CMS Eliminates Medicaid ‘Four Walls’ Rule For Telehealth Behavioral Health Services In Rural Areas

The Centers for Medicare and Medicaid Services (CMS) has amended the Medicaid clinic services regulations to give states the option to cover Medicaid telehealth behavioral health clinic services delivered outside the “four walls” of clinics located in rural areas. The amendment was announced on November 1, 2024, and is included in the calendar year 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-FC). It finalizes exceptions to the Medicaid clinic services four walls requirement for Indian Health Service/Tribal clinics, and, at state option, for rural behavioral health clinics. The rule . . .