G0071 Insurance Policy Changes

HCPCS G0071 is officially defined as "Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only." HCPCS G0071 is referenced in 5 tracked payer policy changes from Highmark, Medicare/CMS, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS G0071 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.