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In Fed rules, the pitcher must be on the rubber for this to be a balk. He can be on the mound, but off the rubber, go to his mouth, and wipe it off without penalty.
That said, if he was on the rubber and went to his mouth:
A) It is a balk if runners are on base. All runners move up one base, and the count remains the same.
B) With nobody on base, one ball will be added to the count. If the count is 3-0, 3-1, or 3-2 at the time, the batter is awarded 1st base.
This is always a big topic in our American Legion pre-games with coaches. Around here they play mostly high school rules until the tournament, then switch to American League rules, where this is a balk if you are on any part of the mound.
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