RHCs and FQHCs are paid an all-inclusive rate (AIR) or national prospective payment system (PPS) rate for any service that is defined as a visit to their facility. A visit may be with a physician, non-physician practitioner (NPP), psychologist or social worker. There are some differences in RHC and FQHC rules, but in general, a […]
Coding Guide – Federally Qualified Health Centers
If you are looking for a guide to coding for Rural Health Center (RHC) or Federally Qualified Health Center (FQHC) visits, here it is. Clinicians in RHCs and FQHCs use CPT® and ICD-10-CM codes to select their services, but these are submitted with HCPCS qualifying visit codes. It’s easy for clinicians in these mission driven […]
Overview of FQHC and RHC Coding | Webinar
Recorded February 20th, 2025
Federally Qualified Health Centers (FQHCs) operate in rural and urban areas, and provide services to Medicare, Medicaid patients and privately insured patients. Rural Health Centers operate in rural areas and also provide services to Medicare, Medicaid and privately insured patients.
RHC and FQHC Update
Background Rural Health Centers (RHCs) and Federally Qualified Health Centers (FQHCs) have specific rules related to coding for service in their clinics. Both submit claims on a UB claim form that shows a revenue code and also includes the specific HCPCS/CPT® codes that were performed. RHCs (generally) are paid an all-inclusive rate for services done […]
Why Not Bill All 99213 Visits in an FQHC?
Why not bill all 99213 visits in an FQHC? (Hint: it’s a good way of telling everyone that they were pretty easy visits.) Practitioners who work in Federally Qualified Health Centers (FQHCs) can get in the habit of billing all level three office visits, understanding that an FQHC is paid under the Prospective Payment System […]
Telemedicine in RHCs and FQHCs
The 2025 Physician Fee Schedule Final Rule, released in Nov. 2024 continues to allow RHCs and FHQCs to perform telehealth through all of 2025. RHC and FQHC Update In April, 2020 CMS released guidance about paying for telehealth services in Rural Health Centers (RHCs) and Federally Qualified Health Centers (FQHCs). These payments were authorized by […]