Coding and Billing Guidelines for FQHCs

Conference Material (Password Required)

During this Webinar, we will discuss the basics of FQHCs for coding and billing. We will review the Medicare G codes and the qualifying codes/services that correlate with the G codes. We will also outline the FQHC billing requirements for multiple visits on the same date of service. We will discuss when a patient is considered a new patient versus an established patient in an FQHC. The training will also outline which services go on which claim form (i.e., UB versus 1500) for Medicare. This webinar will leave plenty of time for questions to be answered during the training.

Learning Objective:

• The attendees will be able to determine if a CPT/HCPCS code is considered a qualified code for Medicare.
• The attendees will be able to identify when multiple visits are allowed to be billed on the same date of service.
• The attendees will understand when a patient is considered new or established for Medicare in the FQHC setting.
• The attendees will know which claim should be submitted for each CPT/HCPCS code.

Areas Covered in the Session:

• G codes and Qualifying Codes
• Multiple visits on the same date of service
• New vs. Established patients
• Which claim form to submit
• Qualified Provider
• Covered Services
• Coding & Compliance Initiatives – Location
• Coding & Compliance Initiatives – G codes
• Qualifying Codes for G0467 (established patient)
• Qualifying Codes for G0468 (IPPE or AWV)
• Qualifying Codes for G0469 (mental health – new patient)
• Example – New Patient
• Example – Established Patient
• Multiple Visits
• Example – Medical and Mental Health
• Billing Requirements
• Billing Requirements – Multiple Visits
• Claims
• Denial Needed
• Covered or Non-Covered Service
• Four Categories of Items and Services NOT Covered under Medicare
• New Patient – Payment Adjustment
• Electrocardiogram (EKG)
• Ancillary Services
• Laboratory Services
• Technical Component

Suggested Attendees:

• Credentialing and Enrollment Specialists
• Credentialing and Enrollment Experts
• Credentialing and Enrollment Leaders
• Healthcare Administrative Teams, Personnel
• Practice Managers
• Healthcare Billing Specialist
• Staff Providing NPI Support, NPPES  Support
• PESC, CPMSM, CPCS
• Staff Providing CAQH Support
• Clinic Managers
• Allied Health Providers
• Advance Health Practitioner
• Credentialing
• Enrollment
• Office Managers
• Operations
• Revenue Cycle
• Coders
• Clinical Directors
• Practice Owners
• Claims Teams
• MSPs

About the Presenter