Distant site is Medicare's term for where the billing practitioner is physically located during a telehealth visit. It is the mirror image of the originating site, which is where the patient is. Together the two terms describe the geographic pair that every Medicare telehealth encounter is built around, and they appear throughout the billing and audit machinery because location has historically determined what can be reimbursed.

Which practitioner types are allowed to bill from a distant site, and whether facilities such as Federally Qualified Health Centers (FQHCs) and rural health clinics qualify, are matters defined by rule rather than assumed — and crucially, several of those permissions are date-bound. A number of the pandemic-era flexibilities that expanded distant-site billing currently run through December 31, 2027, which means the rules can change on a known calendar and a product built around today's allowances may need to adjust.

For a product team, the distant-site concept shows up directly in claims, audits, and the Medicare Physician Fee Schedule, so the practical implication is to capture and record both ends of every visit. A flow that logs only the patient's location, or only the clinician's, will not have the data an audit asks for. Because the underlying permissions have expiration dates, it is also wise to keep the location and eligibility logic configurable rather than hard-coded to current rules. The common pitfall is treating distant-site eligibility as a fixed fact of the system when it is in reality a time-limited, rule-driven parameter that can shift when a flexibility lapses or is extended.

Book cover: Video Encoding, Volume 1 of the Fora Soft Video Engineering HandbookBook cover: Video Streaming, Volume 3 of the Fora Soft Video Engineering HandbookBook cover: AI for Video, Volume 7 of the Fora Soft Video Engineering Handbook

The handbook · 7 volumes

Fora Soft Video Engineering Handbook

The distant site is where the clinician sits, and its network, devices and room setup shape what the patient sees and hears. Our seven-volume handbook covers the whole video stack, and for distant-site setups start with Volume 3: WebRTC calls, players, QoE monitoring and recovery after stalls. Volume 1 covers encoding and Volume 7 real-time AI in calls. Written by Nikolay Sapunov, CEO at Fora Soft.

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