Wiki FQHC - Diabetic Retinopathy Screening

[joycejackson]

Hello,

I am wondering if an FQHC can bill for Diabetic Retinopathy Screening using CPT 92250?

Thanks,
Joyce

 

[Chelle-Lynn]

According to CMS, it is not listed as an exclusion. Generally physician services are a covered benefit under the following criteria:

Chapter 13 - Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services
Physician services are professional services furnished by a physician to a RHC or FQHC patient and include diagnosis, therapy, surgery, and consultation. The physician must either examine the patient in person or be able to visualize directly some aspect of the patient’s condition without the interposition of a third person’s judgment. Direct visualization includes review of the patient’s X-rays, EKGs, tissue samples, etc.

You would need to still bill using the G0466 and G0467 with a qualifying services under these payment codes.