News

Capturing of RCO Data

3/4/2016

TO:    All FQHC Providers

PDF Version

Beginning with service dates of January 1, 2016, FQHCs should bill Medicaid non-covered procedure codes at the detail level. These detail level line items must be billed with a 0.01 (one cent) rate.  Medicaid will zero pay these line items.

This is needed to allow Medicaid to capture details included in the encounter rate in order to determine actuarially sound rates when Regional Care Organizations are implemented.

The codes to be billed are:

• G8476

• G8477

• G8478

• G8510

• 3045F

• 3074F

• 3078F

• 3079F

• 3077F

• 3008F

• 2028F

 

Questions or comments should be directed to Jerri Jackson, Director, Managed Care Division, via e-mail at jerri.jackson@medicaid.alabama.gov or phone at 334-242-5630 or Karen Smith, Associate Director, Clinic Services and Mental Health Programs, via e-mail at karen.watkins-smith@medicaid.alabama.gov or 334-353-4945.