# Medicare 99211



## PamKen (Oct 27, 2015)

We have a lot of medicare 99211 claims that are not being paid.  Is anyone else having this problem.  My clearing house tells me it needs a G code attached and they have been returned to provider.  I do not find where a G code is needed for 99211 on the CMS web site.  We are an FQHC.  

Thank you in advance.


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## erjones147 (Oct 27, 2015)

If it's an FQHC, I think you have to add G0467 (for established)


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## PamKen (Oct 27, 2015)

These visits are with our RN and we have tried the G code as well. With no response from Medicare.


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## mitchellde (Oct 27, 2015)

What is the reason for the encounter?  Any other codes on the claim?  What dx code(s) were assigned ?


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## ntreber (Oct 27, 2015)

if you are an FQHC 99211 is no longer a billable code as it does not require a face to face with the Provider. 
our MAC Noridian has billing information for FQHC's that includes all billable "G" codes and what CPT codes qualify as an FQQHC visit.


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## amys2361 (Nov 2, 2015)

*99211 and FQHC*

We are an FQHC as well and CMS states, that a 99211 is not a billable FQHC encounter. Remember it is thought of as encounter not visit.  CMS states(if I understood correctly) that it would be reimbursed at the encounter prior to the nurse visit or after the nurse visit. Meaning, it is already paid for.


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