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 – Rural Health Centers (RHCs) and Federally Qualified Health Centers (FQHCs)
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
1 CEU expires 2/28/26
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 are paid an all-inclusive rate for services done on […]
Why Not Bill All 99213 Visits in an FQHC?
Practitioners who work in Rural Health Centers (RHCs) Federally Qualified Health Centers (FQHCs) can get in the habit of billing all level three office visits, understanding that for Medicare and Medicaid patients, payment is the same no matter what level of service is reported. Whether the visit was a simple visit or the patient had […]