Special Instructions for Independent and Provider-Based Rural Health Clinics/Federally Qualified Health Center (RHCs/FQHCs) (Rev. 1586,10-06-08)

by  Jared Staheli
June 25th, 2015

Independent and provider-based RHCs and FQHCs do not include charges for influenza virus and pneumococcal vaccines on Form CMS-1450. Administration of these vaccines does not count as a visit when the only service involved is the administration of influenza virus and/or pneumococcal vaccine(s). If there was another reason for the visit, the RHC/FQHC should bill for the visit without adding the cost of the influenza virus and pneumococcal vaccines to the charge for the visit on the bill. FIs/AB MACs pay at the time of cost settlement and adjust interim rates to account for this additional cost if they determine that the payment is more than a negligible amount.

Payment for the hepatitis B vaccine is included in the all-inclusive rate. However, RHCs/FQHCs do not bill for a visit when the only service involved is the administration of the hepatitis B vaccine. As with other vaccines administered during an otherwise payable encounter, no line items specifically for this service are billed on the RHC/FQHC claims in addition to the encounter

References:

Special Instructions for Independent and Provider-Based Rural Health Clinics/Federally Qualified Health Center (RHCs/FQHCs) (Rev. 1586,10-06-08). (2015, June 25). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/special-instructions-for-independent-and-provider-based-rural-health-clinics-federally-qualified-health-center-rhcs-fqhcs-rev-1586-10-06-08-26900.html

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