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CHDP Phase 2 Reminder: FQHC, RHC and IHS-MOA Not Affected by CHDP Code Conversion

August 31, 2017

The following providers are not affected by the Child Health and Disability Prevention (CHDP) Phase 2 code conversion and claim transition, which was effective for dates of service on or after July 1, 2017:

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

FQHCs, RHCs and IHS-MOAs must continue to submit their cost-based claims for CHDP Early and Periodic Screening, Diagnosis and Treatment (EPSDT) preventive well-child health assessments according to their current billing instructions, including submitting a copy of the Confidential Screening/Billing Report Information Only (PM 160 Information Only) form as an attachment to a UB-04 claim.

Claims submitted by FQHCs, RHCs and IHS-MOAs with codes announced for the CHDP code conversion will be denied. These providers should watch the Medi-Cal website and monthly bulletins for their own code conversion, which is scheduled for implementation in October 2017.

Note:

Effective for dates of service on or after October 1, 2017, the FQHC/RHC/IHS-MOA code conversion will establish HIPAA-compliant billing code sets for FQHCs, RHCs and IHS-MOAs. For dates of service on or after that date, these providers are required to submit cost-based claims using the HIPAA-compliant code-sets, including submitting a copy of the PM 160 Information Only form as an attachment to a UB-04 claim.

Providers with questions or concerns may call the Telephone Service Center (TSC) at 1-800-541-5555 from 8 a.m. to 5 p.m., Monday through Friday, except holidays.

Email Address for Questions/Concerns
Providers may submit questions or concerns to CHDPTransition@conduent.com.