CMS Corrects Payment Error for Rural Health Clinics & Federally Qualified Health Centers

Story by Connor Danielowski / September 4, 2025

August 28, 2025 — CMS Announcement

The Centers for Medicare & Medicaid Services (CMS) has issued an important update impacting Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Since January 1, 2025, claims for care coordination services were being incorrectly reimbursed.

CMS has now confirmed the error has been corrected. Effective immediately, Medicare Administrative Contractors will begin adjusting claims retroactively for dates of service on or after January 1, 2025.

Affected Services

The update includes a broad range of care coordination and chronic care management codes, including but not limited to:

• 98975–98977 (Remote Therapeutic Monitoring)
  
• 98980–98981 (Care Coordination/RTM)
  
• 99424–99427 (Principal Care Management)
  
• 99490, 99491, 99437, 99439 (Chronic Care Management)
  
• G0511 (General Care Management for RHC/FQHC)
  
• G3002, G3003 (Principal Illness Navigation)
  
• And other codes related to remote monitoring, behavioral health integration, and care management
  

(See the full CMS announcement for the complete code list: CMS MLN Connects Newsletter – August 28, 2025)

What You Need To Do

Good news: no action is required from providers.

Medicare Administrative Contractors will automatically reprocess claims with the corrected reimbursement rates.

What this does for Clinics and Providers

For clinics and health centers serving rural and underserved populations, every reimbursement dollar matters. With this correction:

• Providers will receive the appropriate, full payment amounts owed.
  
• Retroactive adjustments ensure that past claims dating back to January 1, 2025, will be corrected.
  
• Clinics can continue focusing on patient care, knowing CMS is resolving the financial discrepancies.
  

We know how closely reimbursement policies impact our partners. 

Our team is here to help practices and providers maximize compliance, streamline care coordination services, and improve outcomes.

Connor Danielowski

Chief Operating Officer, Chronic Care Staffing

Connor Danielowski is the Chief Operating Officer at Chronic Care Staffing, where he leads operations, strategy, and growth initiatives focused on delivering high-impact virtual care solutions. He brings a unique blend of clinical service knowledge and financial expertise to help healthcare organizations implement and scale Chronic Care Management (CCM), Remote Patient Monitoring (RPM), and other virtual care management services.

Connor began his career in investment banking and private equity, where he focused on investing in healthcare businesses and working closely with management teams to drive revenue growth and profitability. This experience shaped his hands-on, results-oriented approach to healthcare operations today.

He holds a degree in Accounting from Washington & Lee University and brings both analytical rigor and a patient-first mindset to his role. In addition to his work at Chronic Care Staffing, Connor serves on the development board for the MUSC College of Nursing. He lives in Charleston, SC, with his wife and son.

Categories: Chronic Care Management News