Keyword Analysis & Research: is cpt 0064a separately payable for fqhc

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Frequently Asked Questions

What are the changes to the HCPCS code for FQHCs?

Mental Health Services Furnished via Telecommunications Technologies for FQHCs Change to the general care management HCPCS code G0511 to replace G2064 and G2065 with CPT code 99424 and 99426 To provide as much support as possible to FQHCs and their patients during the COVID-19 (PHE), we have made several changes to FQHC requirements and payments.

Can an FQHC Bill and get payment under the PPS?

Beginning January 1, 2022, an FQHC can bill and get payment under the FQHC PPS respectively, when their employed and designated attending physician provides services during a patient’s hospice election. GV modifier on the claim line with the payment code (G0466 - G0470) each day a hospice attending physician service

How are FQHCs paid?

FQHCs are paid under PPS per encounter for Medicare covered services, rate does not include services that are not defined as FQHC services. Facility PPS rate is determined by multiplying the PPS Base Rate by the location's Geographical Adjustment Factor (GAF) FQHC is paid the lesser of the amount charged on the payment code or the PPS rate.

Can RHCs and FQHCs provide and Bill for care management services?

Starting with the calendar year 2022 and going forward, health care providers at RHCs and FQHCs may provide and bill for CCM, TCM, and other care management services for the same beneficiary during the same service period as long as all requirements for billing each code are met.


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