FQHC Billing Approved Preventive Services under the PPS

70.2 - FQHC Billing Approved Preventive Services under the PPS (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 (PS) HCPCS code and the associated charges. For example, if the total charge for the visit is $150.00, report the total charges for the encounter. NOTE: Do not carve out the charges for the approved preventive services. The service lines should be coded as follows: Appropriate Rev Code Appropriate HCPCS Code MOD DOS Charges 0521 G0468 - FQHC Payment Code (G-code) 10/01 150.00 0771 G0439 - PS code 10/01 75.00 In the example above, the services reported under the encounter/visit service line will receive the PPS payment. The charges reported on this line should include the charges for the approved preventive service. The coinsurance will be applied to the charges reported on the encounter service line. Coinsurance will not be applied to the charges reported for the approved preventive service. The qualified preventive service reported on the second revenue line will not receive payment. NOTE: A qualified HCPCS code visit must be reported if the preventive service is not a qualified visit.