November 7, 2016
Attention Rural Health Clinic (RHC) Providers!
Ensure your claim billing staff and electronic vendors are aware of the RHC billing guidelines to avoid your claims RTP’ing for Reason Code 39910. If you are receiving this reason code, we encourage you to fully review the claim's external narratives and pay special attention to the CMS resources below that highlights:
- Required HCPCS reporting from the RHC Qualifying Visit List
- Changes to reporting specific codes, and
- The submission of the CG modifier to the line with all the charges subject to coinsurance and deductible.
These important changes have been implemented! CGS urges you to stay abreast of the important news that directly affects your facility. Time and resources are valuable; therefore, save both by keeping up with the CMS RHC news and billing guidelines.
- MLN Matters® article MM9269
- MLN Matters® article SE1611
- Rural Health Clinics (RHCs) Reporting Requirements Frequently Asked Questions (FAQs) (Revised 10-14-16)
- CMS Rural Health Clinic Center Website - Spotlights
Reviewed: 12.15.23