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Update: FQHC, RHC and IHS/MOA Billing Not Affected by CHDP Code Conversion

June 8, 2017

The following provider types will not be affected by the Child Health and Disability Prevention (CHDP) Phase 2 code conversion and claim transition as originally indicated:

  • Federally Qualified Health Centers (FQHCs)
  • Rural Health Clinics (RHCs)
  • Indian Health Services/Memorandum of Agreement 638 Clinics (IHS/MOAs)

FQHCs, RHCs and IHS/MOAs should continue to submit their cost-based claims for CHDP Early and Periodic Screening, Diagnosis and Treatment (EPSDT) well-child assessments according to their current billing instructions, including the following:

  • Submitting a copy of the Confidential Screening/Billing Report Information Only (PM 160 Information Only) form as an attachment to a UB-04 claim.
  • Or

  • Submitting a PM 160 Information Only form as an electronic Computer Media Claim (CMC)

FQHC, RHC and IHS/MOA providers are encouraged to watch for updates to the FQHC, RHC, IHS/MOA code conversion, which is scheduled for implementation in October 2017.

The CHDP code conversion and claim transition is effective for CHDP claims with dates of service on or after July 1, 2017. The implementation eliminates billing with two-digit local procedure codes and requires use of national HCPCS procedure codes and modifiers that comply with HIPAA requirements. In addition, the project transitions providers to billing on national CMS-1500 or UB-04 claim forms.

Email Address for Questions/Concerns
Providers may submit questions or concerns regarding the CHDP code conversion and claim form transition to CHDPTransition@conduent.com.