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How to Bill 2 Mental Health Visits on same day for FQHC

Does anyone know how to Bill 2 Mental Health Visits on the same day for FQHC electronically? The codes I have are 90792(telemedicine visit) and 90837 and the G code of G0470 automatically populates with each one as it is added.

I have billed an E/M Office visit code and mental health code before but I cant get this one to work and it says that a modifier can’t be used. Any suggestions will be greatly appreciated! TIA!

Medical Billing and Coding Forum

Looking for best practice for billing Medicare for a Naturopathic provider in an FQHC

Looking for best practice for billing Medicare for a Naturopathic provider in an FQHC setting. We have a large Medicare population in our FQHC wanting to see our Naturopathic Physician. We have informed them that Medicare does not currently cover services provided by a Naturopathic Physicians and they are requesting we bill Medicare anyway. The patients are given an ABN to complete.
What is the best way to bill this to let Medicare know that we know services are not covered but the patient is requesting it be billed for proof of denial. Is there a modifier we should be using? I know there is a modifier for excluded services but the service would be covered if provider by a different provider. I have never worked with or billed for a Naturopathic provider so any help would be appreciated.

Medical Billing and Coding Forum

FQHC Dual encounters, what constitutes “significant additional work”

When working pediatric notes, as an FQHC we are allowed to bill for a dual visit "whenever a problem or abnormality (i.e., exercise-induced asthma, migraine headaches, otitis media, prescription management) is addressed and requires significant additional work to perform the required key components and is medically necessary". We have a note that is documented as "stable on medication, but on drug holiday for the summer. Gave mom instructions on how to restart medications". Can I get your thoughts on if this would fall under prescription drug management?
:confused:
What is a general length of time to which "restarting medication" is considered significant? Your input is greatly appreciated.

Medical Billing and Coding Forum

HRT injections in FQHC setting

I work for an FQHC in California and there are so many limitations on the codes we can bill for etc. I was wondering if anyone could please share any resources they may know of regarding FQHC’s being able to bill for Hormone Replacement Therapy injections in a sort of group type setting vs. the typical face to face encounters. I can’t seem to find out any info that relates to both the visit type in an actual FQHC clinic. Please any information or resource you could direct me to would be greatly appreciated. Thank you in advance!!

Medical Billing and Coding Forum

Billing IOP in an FQHC

Hi all,

I work for an FQHC in CT that is looking to start and IOP program, does anyone have any experience in billing this? Everything I’ve found so far leads to H0015 and S9480 billed on a UB but we bill everything (except Medicare, which doesn’t pay for IOP) on a HCFA so I’m wondering if we just need to unbundle each service to bill professional on a HCFA.

TIA,
Shannon

Medical Billing and Coding Forum

FQHC Billing Lab Services to Medicare Advantage plans

Hi,
I work for an FQHC in Hawaii and we are having issues with billing PPD tests and other lab services to Medicare Advantage plans like UHC, WellCare, etc.
Is there anyone else billing/coding for FQHCs who can share how they are billing labs to Medicare plans?

According to the Medicare FQHC Policy Manual under the subcategory Description of Non RHC/FQHC Services regarding lab services:

Quote:

Laboratory services – Although RHCs and FQHCs are required to furnish certain laboratory services (for RHCs see section 1861(aa)(2)(G) of the Act, and for FQHCs see section 330(b)(1)(A)(i)(II) of the PHS Act), laboratory services are not within the scope of the RHC or FQHC benefit. When clinics and centers separately bill laboratory services, the cost of associated space, equipment, supplies, facility overhead and personnel for these services must be adjusted out of the RHC or FQHC cost report. This does not include venipuncture, which is included in the AIR when furnished in an RHC by an RHC practitioner or furnished incident to an RHC service, and it is included in the per-diem payment when furnished in an FQHC by an FQHC practitioner or furnished incident to an FQHC service.

Does this mean that we should be billing for labs on a CMS-1500 under the rendering provider’s NPI instead of on a UB-04 under our FQHC’s NPI since they are not FQHC services, and expect to get separate reimbursement? We have the billing staff insisting that all of our UnitedHealthcare should be billed out on UB-04 forms regardless of the services we are billing for.

Any assistance is greatly appreciated!

Medical Billing and Coding Forum

FQHC Chiropractic Services billed to Medicare

We are an FQHC located in Ohio and recently added Chiropractic Services. Medicare’s FQHC guidelines state the Chiropractic is covered however, it does not have CPT’S 98940 or 98941 listed as "Qualified visit" attached to a "G" code.

Can an FHQC get reimbursed for Chiropractic services rendered to a Medicare patient?

Any guidance will be greatly appreciated.

Thank You!

Patty Leber

Medical Billing and Coding Forum