FQHC Reason Code 70393

FQHC Reason Code 70393
Current Status
Date
Initial
August 24, 2020
Status: Reason Code 70393 was created to address the reprocessing of all FQHC claims with HCPCS code G2025 with line item dates on or after January 27, 2020.
Provider Action: No action is necessary. There is no need for providers to contact the provider contact center (PCC) regarding this matter.
Identified Date
July 6, 2020
Issue 
Section 3704 of the CARES Act authorizes FQHCs to furnish distant site telehealth services to Medicare beneficiaries during the COVID-19 Public Health Emergency (PHE).  
 
Requirements for FHQCs were as follows:
  • Must report three HCPCS/CPT codes for distant site telehealth services
    • the FQHC Prospective Payment System (PPS) specific payment code (G0466, G0467, G0468, G0469 or G0470)
    • the HCPCS/CPT code that describes the services furnished via telehealth with modifier 95 and G2025
These claims were to be paid at the FHQC PPS rate only to be reprocessed beginning July 1, 2020, at the rate of $92.03.
FHQC providers were advised to hold claims without a FQHC qualifying visits code (G0466, G0467, G0468, G0469 or G0470) until July 1, 2020, then bill with HCPCS code G2025.
Beginning July 1, 2020, FQHCs are required to submit HCPCS code G2025. Modifier 95 can be billed but not required.
Additional Resource: Listing of FQHC payment codes and Qualifying Visits (PDF, 334 KB).

Article Update Notification
Please notify me when this article has been updated.

Would you like to know when this article is updated? Sign up for Article Update Notifications below and we'll send you an email with the new version automatically.

Please check your spam/junk folder as your notification email maybe delivered there.

Email Address:
Please enter this four-digit number in the CAPTCHA Code field: 7066