We are a FQHC and have been getting denials from Medicare stating that the revenue codes are invalid or missing. Rural Health Clinics and Federally Qualified Health Centers. I am trying to figure out some rev codes for MEdicare. Can anyone help me or point me in the right direction? DESCRIPTION. All other lines on the claim should have the revenue code most appropriate for the service. www.cms.gov. Any help or guidance would be greatly appreciated. REVENUE CODE HCPCS CODE MODIFIERS 052X G0467 (or other appropriate FQHC Specific Payment Code) No Modifier 052X 99214 (or other FQHC PPS Qualifying Payment Code) 95 052X G2025 95 For Telehealth Service Claims Starting July 1st REVENUE CODE HCPCS CODE MODIFIERS 052X G2025 95 (Optional) Should the J1885 be billed for the 0521 as well? Rural health clinics and federally qualified health centers. The RHC/FQHC assigns a revenue code for each type of service provided … CMS Manual System – CMS.gov. In order to be reimbursed, an FQHC or RHC that submits a UB-04 or 837 Institutional (837I) electronic transaction must have at least one (1) claim line that identifies revenue code 0529 for FQHCs or revenue code 0521 for RHCs. FQHC/RHC Code Conversion – Policy Effective October 1, 2017 Current Billing Codes New Billing Codes Local Code Description National Code Description Revenue Code Procedure Code Modifier Billing Instructions 01 Medical, per visit code Medical, per visit 0521 T1015 Revenue code with HCPCS Level II code 02 Crossover claims Crossover claims PLEASE NOTE: Differences in State Medicaid rules can vary greatly, please confirm information with Montana Medicaid. FQHC “Payment” code Psychotherapy (QVL) 1/1/2019. Here is one example. 0636 Pharmacy, Drugs requiring detailed coding. Revenue code - In relation to inpatient admissions • Revenue Code 760 is not allowed because it fails to specify the nature of the services. G0468; G0439 . We are currently billing the 0521 revenue code for our 99213 and a 0636 revenue code for J1885. The revenue code … www.cms.gov. View a list of revenue codes which are four digit numbers that are used on hospital bills to tell the insurance companies either where the patient was when they received treatment, or what type of item a patient might have received as a patient. These are the CPT codes I need the revenue code too. Revenue codes: 0771 Preventive Care Services, Vaccine Administration. I bill for FQHC. FQHC Claims for Telehealth Services January 27, 2020 , through June 30, 2020, when cost sharing is waived Revenue Code HCPCS Code Modifiers 052X G0467 (or other appropriate FQHC Specific Payment Code N/A manual to add existing provider range 4900 – 4999 in the list of applicable … CORFs, RHCs and FQHCs shall use revenue code 0900 to report psychiatric/. FQHC Behavioral Health Billing Codes FQHC Providers are reimbursed at PPS rate for all threshold visits regardless of service code for Medicaid visits. Sample of FQHC Bill REVENUE CODE; CPT / HCPCS II CODE. What is the appropriate revenue code if a patient is in a certified skill nursing facility (SNF) bed, benefits are exhausted under Medicare and/or criteria is no longer being met, and the physician visits the patients in the facility and provides FQHC services? G0470; 90832. Jan 1, 2017 … • Revenue Code 761 is acceptable when an exam or relatively minor treatment or procedure is performed. FQHC “Payment” code; AWV, initial (QVL) 1/1/2019; 0900. DOS: 0521. 15. Federally Qualified Health Center – CMS.gov. Independent and provider-based rural health clinics (RHCs) and federally qualified health centers (FQHCs) do not include charges for the COVID-19 vaccine and monoclonal antibodies on a claim form. 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