FQHC Radiology Services Reimbursement Methodology Revision Effective Aug. 1, 2022, only the technical component of an onsite radiology service performed at FQHCs/RHCs will be separately reimbursed by Medicaid
Effective Aug. 1, 2022, only the technical component of an onsite radiology service performed at federally qualified health centers (FQHCs)/rural health clinics (RHCs) will be separately reimbursed by Medicaid. The professional component of these services will no longer be reimbursed using the radiology CPT codes after Aug. 1, 2022.
The technical component of an RHC or FQHC service includes diagnostic tests such as x-rays and electrocardiograms (EKGs). When an on-site radiology service and a core service are performed on the same date of service, the FQHC or RHC bills on two separate claims: the professional encounter is included under the T1015 procedure code and the technical component is billed using the FQHC or RHC rendering provider number.
Modifier TC appended to the procedure code reports the technical component of such procedures. FQHCs and RHCs shall bill for the technical component of an onsite radiology service by billing the correct CPT code with modifier TC.
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