Get the free CHDP/EPSDT Reporting and Billing Requirements for FQHCs and RHCs

This document provides guidelines for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) regarding the reporting and billing requirements for the Child Health and Disability

How to fill out chdpepsdt reporting and billing

How to fill out CHDP/EPSDT Reporting and Billing Requirements for FQHCs and RHCs

1. Gather all necessary patient information, including demographic data and medical history.
2. Review the CHDP/EPSDT guidelines to understand the required services and eligibility criteria.
3. Complete the billing forms accurately, ensuring all required fields are filled out.
4. Document any services provided during the visit that align with the CHDP/EPSDT requirements.
5. Verify that the billing codes used correspond to the services rendered and are compliant with CHDP/EPSDT regulations.
6. Submit the completed forms and billing documentation to the appropriate agency or payer.
7. Keep copies of all documentation for your records and follow up on any submitted claims.

Who needs CHDP/EPSDT Reporting and Billing Requirements for FQHCs and RHCs?

1. Federally Qualified Health Centers (FQHCs) that provide primary care services to low-income populations.
2. Rural Health Clinics (RHCs) that offer essential health services in rural areas.
3. Healthcare providers involved in caring for Medicaid-eligible children and adolescents.
4. Administrators managing health programs that require compliance with CHDP/EPSDT requirements.

People Also Ask about

How do FQHCs bill?

FQHC services must be billed with the FQHC revenue codes listed below and a Healthcare Current Procedural Coding System (HCPCS) code describing the encounter: 0521 - Clinic visit by member to FQHC. 0522 - Home visit by FQHC practitioner.

What are the CCM billing codes for FQHC?

Beginning January 1, 2025, RHCs and FQHCs can bill individual CCM codes (99437, 99439, 99487, 99489, 99490, 99491, G3002, G3003).

What is the difference between an RHC and FQHC?

RHCs operate exclusively for the purpose of providing primary care services to Medicare patients located in rural and shortage areas; FQHCs provide primary care services and dental care services to rural/urban areas and shortage areas.

Can FQHC bill for remote patient monitoring?

RPM services are billable. Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can receive a separate payment for these services. Requirements include: An established patient relationship.

What is the meaning of RHC?

RPM services are billable. Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can receive a separate payment for these services. Requirements include: An established patient relationship.

What is the difference between FQHC and RHC?

Medicare-certified rural health clinics (RHC) are located in a rural areas designated as a shortage area, is not a rehabilitation agency or a facility primarily for the care or treatment of mental diseases. Federally qualified health centers (FQHC) are located in both rural/urban areas designated as a shortage area.

Can FQHC bill for remote patient monitoring?

A Federally Qualified Health Center (FQHC), more commonly known as a Community Health Center (CHC), is a primary care center that is community-based and patient directed.

For pdfFiller’s FAQs

What is CHDP/EPSDT Reporting and Billing Requirements for FQHCs and RHCs?

The CHDP (Child Health and Disability Prevention) and EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) reporting and billing requirements are protocols that Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) must follow to document and bill for services provided to children under the Medi-Cal program. These guidelines ensure that health care providers meet state and federal standards for preventive health care services.

Who is required to file CHDP/EPSDT Reporting and Billing Requirements for FQHCs and RHCs?

FQHCs and RHCs that provide services under the Medi-Cal program are required to file CHDP/EPSDT reporting and billing requirements. This includes healthcare providers who offer preventive care services to eligible children.

How to fill out CHDP/EPSDT Reporting and Billing Requirements for FQHCs and RHCs?

To fill out the CHDP/EPSDT reporting and billing requirements, providers must accurately document the services rendered, including the child's demographic information, health assessments, and any screenings or vaccinations provided. This information should then be submitted through the designated billing forms or electronic systems as specified by the state health department.

What is the purpose of CHDP/EPSDT Reporting and Billing Requirements for FQHCs and RHCs?

The purpose of the CHDP/EPSDT reporting and billing requirements is to ensure that children receive necessary preventive health services, to maintain accurate records for appropriate reimbursement to healthcare providers, and to monitor the health status of children served under the Medi-Cal program.

What information must be reported on CHDP/EPSDT Reporting and Billing Requirements for FQHCs and RHCs?

The information that must be reported includes the child's name, date of birth, insurance information, the specific screenings and services provided, dates of service, and any follow-up care or referrals made. Additionally, providers must ensure compliance with state reporting formats and guidelines.