Wiki Anyone billing their BH claims under FQHC to Medicare???

smontague

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Just wondering if anyone else out there is billing their Behavioral Health claims to Medicare under FQHC billing. My office performs both medical and BH services and we have been filing our medical claims under FQHC for a few years, but we just changed our scope of service to include BH claims too, but we are having a horrible time trying to figure out how to bill them correctly.

On the medical side we file the visits to one Medicare and then we split off any diagnostic services and bill them to the other Medicare...wasn't sure if this was the same for the BH side, meaning - if we have a therapy visit would it go the same as a medical claim/encounter and then if we do any BH testing it would be billed as a diagnostic service??

If there is anyone who has done this or could point me in the right direction I would really appreciate it.

Thanks,
Sam :)
 
I bill at an FQHC and the BH claims are not split up for billing. You are using the 0900 revenue code? What kind of rejections are you receiving back?
 
Hi - actually I think we figured this one out finally. We are billing 0900 for our therapy visits that are subject to the Mental Health Treatment Limitation and all the diagnostic therapy services (i.e. initial diagnostic interview and psych testing visits) are going under 0521.

Thanks!
 
Fqhc

Hi

New to coding/billing and would love to know everything there is out there about FQHC billing. I was glad to read you post!
 
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