Wiki need help on coding

[jbhuju]

hello everyone,
as being new coder in FQCH i need help. we were been billing covid vaccine to medicare but someone told us as being FQHC we can not bill medicare not even admin code. so we are adjusting off the admin code instead of billing it out. please some one could help me how this going to work? as being FQHC how do we need to bill medicare and what revenue code should we use? i live in arizona. thank you in advance

 

[thranowski]

I found this on CMS.gov: https://www.cms.gov/medicare/covid-19/medicare-billing-covid-19-vaccine-shot-administration

Billing for RHCs & FQHCs​

For Rural Health Clinics (RHCs) and Federally Qualified Health Clinics (FQHCs), Medicare pays for administering COVID-19 vaccines at 100% of reasonable cost through the cost report. RHCs and FQHCs should also use the cost report to bill for administering COVID-19 vaccines to patients enrolled in a Medicare Advantage Plan.

Is that relevant to you? I am not familiar with FQHC, just trying to help.

When we called our state (FL) about the COVID vaccines, they told us we were allowed to bill up to $21 for the admin fee, so that's what we billed to all insurances for the COVID vaccine. We were instructed to use the vaccine CPT at $.01 and then the admin code for the vaccine at $21.

 

[jbhuju]

I found this on CMS.gov: https://www.cms.gov/medicare/covid-19/medicare-billing-covid-19-vaccine-shot-administration



Is that relevant to you? I am not familiar with FQHC, just trying to help.

When we called our state (FL) about the COVID vaccines, they told us we were allowed to bill up to $21 for the admin fee, so that's what we billed to all insurances for the COVID vaccine. We were instructed to use the vaccine CPT at $.01 and then the admin code for the vaccine at $21.

thank you so mush .
yes it does help. before we were billing vaccine and admin code and medicare was paying too then later we were told as being we were not suppose to bill medicare at all then we started adjusting off the balance without billing out. so if we do not bill then how we going to get that on cost report then.
so i start doing research and found we suppose to bill admin fee only. FQHC is really confusing me how to bill.
do you have any idea about modifier so that medicare will not pay but later will pay on cost report?

 

[thranowski]

thank you so mush .
yes it does help. before we were billing vaccine and admin code and medicare was paying too then later we were told as being we were not suppose to bill medicare at all then we started adjusting off the balance without billing out. so if we do not bill then how we going to get that on cost report then.
so i start doing research and found we suppose to bill admin fee only. FQHC is really confusing me how to bill.
do you have any idea about modifier so that medicare will not pay but later will pay on cost report?

Sorry, no. I don't know anything about FQHC. When we inquired about COVID vaccines, we were supplied with a google sheets form that allowed us to enter in all of the information for the patients who received it. I'm not sure if they would just expect something like that from you.

 

[jbhuju]

Sorry, no. I don't know anything about FQHC. When we inquired about COVID vaccines, we were supplied with a google sheets form that allowed us to enter in all of the information for the patients who received it. I'm not sure if they would just expect something like that from you.

thank you for help