UMTRC Webinar: Evaluation and Management Billing for FQHCs

Discuss: The New 2021 Evaluation & Management guidelines
Share: How to apply them
Discuss: Proper FQHC G-payment code
Review: Chronic Care Management services and Principal Care Management for FQHCs
Discuss: an overview of Care Management Services for FQHCs
Review: Virtual Communication services for FQHCs
Discuss: detailed service and billing requirements
Speaker: Mr. Charles James Jr., President and CEO
North American Healthcare Management Services
This session will discuss reporting Evaluation and Management Services to Medicare as a Federally-Qualified Health Center. We will include a review of the new 2021 Evaluation and Management guidelines and how to apply them to FQHC billing. We will define FQHC providers, locations, and services. It is important that participants come away with a detailed understanding of the difference between “FQHC services” and “Non-FQHC services”, how each are billed, and how to avoid commingling problems. We will explore proper FQHC G-Payment code (G0466, etc.) for established and new patients, office visits, preventive services, multiple encounters, and minor surgical procedures. Incident-to services and venipuncture examples will be reviewed. We will take a look at how the Medicare payment and patient cost-sharing balances are calculated in relation to charge amounts and the FQHC PPS Encounter Rate. We will review several different detailed claim scenarios. Participants will leave with a detailed understanding of billing Evaluation and Management Codes in a FQHC.

[@musicmaker85]

Thank you for making this freely available. I am a new coder for a FQHC organization. It's a lot of new information to take in all at once. How does FQHC reimbursement work for Medicaid and commercial payers since G codes only apply to Medicare?

[@Little_shoe]

This has been so helpful for someone just learning FQHC coding! Thank you!

[@aleecewhite3919]

If we are an independently owned FQHC by a board of directors, not associated with a hospital, do we bill on a CMS-1500 or UB-04??

[@brianfisher9909]

Can you bill a fqhc cpt awv and an em code together with modifier on the em code? If on this visit there was more done than the awv?

[@StacyGustafson-f9t]

Martinez Christopher White Frank Clark Amy

[@CarolineLauren-l9v]

Hall Michael Taylor Edward Harris Kimberly

[@NorbertKates-w2r]

Brown Paul Robinson David Jackson Donna