RHCs Billing Approved Preventive Services

70.1 - RHCs Billing Approved Preventive Services (Rev. 13264, Issued:06-09-25; Effective: 06-02-25; Implementation: 06-02-25) An additional line with the appropriate site of service revenue code in the 052X series should be submitted with the approved preventive service HCPCS code and the associated charges. For example, if the total charge for the visit is $150.00, and $50.00 of that is a qualified preventive service, the service lines should be coded as follows: Appropriate Rev Code Appropriate HCPCS Code MOD DOS Charges 0521 99212 - Encounter Visit CG 10/01 100.00 0521 G0439 - Preventive Service Code (PS) 10/01 50.00 In the example above, the encounter service line will receive the AIR payment. The charges reported on this line should not include the charges for the approved preventive service. Coinsurance and deductible will be accessed based on the charges reported on this service line. The qualified preventive service reported on the additional service line will not receive payment, as payment is made under the AIR for the services reported under the encounter service line. Coinsurance and deductible are accessed based on the charges reported on the preventive services line.