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Medicare FQHC Resources
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Medicare FQHC Resources



Centers for Medicare & Medicaid Services website

Enrollment

National Plan and Provider Enumeration System (NPPES) (NPI)

2015 | Website | Source: Centers for Medicare & Medicaid Services
Health Centers must obtain a National Provider Identifier (NPI) to appropriately bill for services.

 

Medicare Enrollment Application-Institutional Providers (CMS 855A Enrollment Form)

2016 | PDF | Source: Centers for Medicare & Medicaid Services

Each Health Center site must file this form to initiate and maintain reimbursement under the FQHC benefit.

 

Medicare Enrollment Application-Physicians and Non-Physician Practitioners (CMS 8551 Enrollment Form)

2016 | Website | Source: Centers for Medicare & Medicaid Services

Physicians and non-physician practitioners can apply for enrollment in the Medicare program or make a change in their enrollment information using the Internet-based Provider Enrollment, Chain and Ownership System (PECOS).

 

The Basics of Internet-based Provider Enrollment, Chain and Ownership System (PECOS) for Provider and Supplier Organizations 

2015 | PDF | Source: Department of Health and Human Services, Centers for Medicare & Medicaid Services Helpful tool that provides basic information on registering providers using Provider Enrollment, Chain and Ownership System (PECOS) CMS Website

 

Reimbursement

 

Chronic Care Management 2016
2016 | PDF | Source: Centers for Medicaid & Medicare Services  
Provides information on new Chronic Care Management documentation and billing requirements.

 

Chronic Care Management Fact Sheet 2016
2015 | PDF | Source: Centers for Medicaid & Medicare Services  
Fact Sheet describing Chronic Care Management requirements.

Chronic Care Management FAQ’s 
2015 | PDF | Source: Centers for Medicaid & Medicare Services  
Frequently asked questions related to Chronic Care Management.

RHC/FQHC Billing Guide   
Provides billing information for both RHC’s and FQHC’s.

Medicare Secondary Payer Billing Guide
2015 | PDF | Source:  Centers for Medicaid & Medicare Services  

Scenarios and Coding Instructions for Submitting Requests to Reopen Claims Beyond the Claim Filing Timeframes

2015 | PDF | Source: Centers for Medicaid and Medicare Services  

 

Chronic Care Management 2016 
Provides information on new Chronic Care Management documentation and billing requirements.

CCM Fact Sheet 2016  
Fact Sheet describing requirements.

 

CCM FAQ’s  
Frequently asked questions related to Chronic Care Management

 


Prospective Payment System (PPS) 2016

 

Specific Qualified Payment Codes 2016

2015 | PDF | Source: Centers for Medicaid & Medicare Services  
Provides a list of qualifying visit codes and corresponding PPS G codes.

 

PPS FAQ’s
2015 | PDF | Source: Centers for Medicaid & Medicare Services  
List of frequently asked questions related to PPS billing.

 

Preventative Services Chart 2016
2015 | PDF | Source: Centers for Medicaid & Medicare Services  

Information on preventative services as it relates to FQHC’s

 

Medicare Learning Network

2016 | Website | Source: Centers for Medicare & Medical Services

National articles designed to inform Medicare fee-for-service providers about the latest changes to the Medicare Program. Subscribe to Medicare MLN Connects Provider E News

 

Medicare for Michigan & Indiana Providers  J8 MAC Part A

2015 | Website | Source: WPS Health Insurance

 
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