FQHC/CHC/RHC billing isn't straightforward. Join this session to learn key details about billing professional and institutional/UB codes, how to make sure you're optimizing your practice management software, and how to leverage the coding for better utilization reporting.
Key Topics
- Reimbursement differences: Medicare Part A/Medicaid PPS contract rates vs. Part B FFS payments
- Split billing rules, including billable CPTs for Part A (G0466-G0470) vs. Part B
- Qualifying CPTs mapped to FQHC PPS codes, with revenue codes like 0521 for Medical, 0900 for behavioral, 0636 for Vaccines and 0771 for Admin UB-04 claims
- Claim submission details: Forms (UB-04 vs. CMS-1500), Type of Bill (771 for FQHC/711 for RHC), and POS (50 for FQHC/72 for RHC)
- Special services: Telehealth guidelines (G2025) and 2025 vaccine/admin code reimbursements (real-time claims)
- Medicaid Wrap methodology for cost-based adjustments beyond Medicare payments
