In a FQHC, flu vaccines and pneumo vaccines are included on the Medicare Cost Report.
99211 visits cannot be billed as a FQHC encounter.
A FQHC billable service must include a face to face visit with a core provider. Clinical assistants or nurses are not core providers.
If you provide a flu vaccine or pneumo vaccine you should claim the appropriate administration code (90471) along with your vaccine code on your cost report.
Cms raised the RVU value of 90471 so billing a 99211 in addition to this is incorrect unless you have a medically necessary diagnosis to support billing 99211 in addition to the administration code for the flu vaccine.
If you do have a medically necessary diagnosis go ahead and bill 99211 to Medicare Part B only.
Claim the cost for the admin and flu vaccine on your Medicare cost report.
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