I 
117TH CONGRESS 
1ST SESSION H. R. 2228 
To allow for payment of outpatient critical access hospital services furnished 
through telehealth under the Medicare program. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 26, 2021 
Mr. KILDEE (for himself and Mr. WENSTRUP) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committee on Ways and Means, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To allow for payment of outpatient critical access hospital 
services furnished through telehealth under the Medicare 
program. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Rural Behavioral 
Health Access Act of 2021’’. 
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SEC. 2. ALLOWING FOR PAYMENT OF OUTPATIENT CRIT-
ICAL 
ACCESS 
HOSPITAL 
SERVICES 
FUR-
NISHED THROUGH TELEHEALTH UNDER THE 
MEDICARE PROGRAM. 
(a) IN GENERAL.—Notwithstanding section 1834(m) 
of the Social Security Act (42 U.S.C. 1395m(m)) and sub-
ject to subsection (b), the Secretary of Health and Human 
Services shall provide payment under section 1834(g) of 
such Act (42 U.S.C. 1395m(g)) for outpatient critical ac-
cess hospital services consisting of behavioral therapy serv-
ices furnished by a critical access hospital to an individual 
on or after January 1, 2021, via telecommunications tech-
nology, notwithstanding the fact that such individual is 
not located at such hospital. 
(b) INITIATION OF SERVICES VIA TELEHEALTH.—In 
the case of an individual receiving services described in 
subsection (a) from a critical access hospital, if such indi-
vidual has not, prior to receiving such services, received 
in-person care at such hospital, payment shall be made 
to such hospital in accordance with such subsection only 
if such services complement a plan of care that includes 
in-person care to be furnished at such hospital not later 
than 1 year after the date such services are furnished. 
(c) DEFINITIONS.—For purposes of this section: 
(1) CRITICAL
ACCESS
HOSPITAL.—The term 
‘‘critical access hospital’’ has the meaning given 
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such term in section 1861(mm)(1) of the Social Se-
curity Act (42 U.S.C. 1395x(mm)(1)). 
(2) OUTPATIENT
CRITICAL
ACCESS
HOSPITAL 
SERVICES.—The term ‘‘outpatient critical access 
hospital services’’ has the meaning given such term 
in section 1861(mm)(3) of such Act (42 U.S.C. 
1395x(mm)(3)). 
(3) TELECOMMUNICATIONS TECHNOLOGY.—The 
term ‘‘telecommunications technology’’ means a com-
munications system permitting two-way, real-time 
interactive communication between the individuals 
and health care professional and includes a commu-
nications system consisting of only audio capabili-
ties, but only if such individual does not have access 
to a communications system with audio-visual capa-
bilities. 
Æ 
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