CMS Spotlight – new 2018 FQHC Care Management Services

CMS has announced new payment rules for FQHC Care Management Services, effective as at January 1, 2018.

  1. FQHCs can receive payment for Chronic Care Management (CCM) or general Behavioral Health Integration (BHI)services when 20 minutes or more of CCM or general BHI services are furnished and G0511 is billed either alone or with other payable services on an FQHC claim.
  2. FQHCs can receive payment for psychiatric Collaborative Care Model (CoCM)services when 70 minutes or more of initial psychiatric CoCM services or 60 minutes or more of subsequent psychiatric CoCM services are furnished and G0512 is billed either alone or with other payable services on an FQHC claim.

2018 care management payment rates are:

  • TCM – Same as payment for an RHC or FQHC visit
  • CCM or General BHI – The 2018 rate is $62.28
  • Psychiatric CoCM – The 2018 rate is $145.08

New billing codes have been created and can be used on the same encounter to generate new revenue streams. For more information and FAQs, visit the CMS website.

Make sure you take advantage of this opportunity! If you need assistance with implementation, contact us to see how we can help.

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