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FQHC/RHC/IHS-MOA Code Conversion Reminder

July 5, 2017

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 Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) and Indian Health Services – Memorandum of Agreement (IHS-MOA) 638, clinics.

The Health Insurance Portability and Accountability Act (HIPAA) was authorized by Congress in 1996. HIPAA mandates uniform, national standards for information submitted by health care providers on claims, including health care services, procedures and personal health information.

These HIPAA-compliant billing code sets will replace local codes currently in use by FQHCs, RHCs and IHS-MOA clinics for medical and/or mental health services. Code crosswalks for this conversion are available on the HIPAA: Code Conversions Web page of the Medi-Cal website under the FQHC/RHC/IHS-MOA area:

Note:

New code sets listed in these crosswalks will be billable on or after October 1, 2017.

Additional information regarding this code conversion will publish throughout 2017 in the NewsFlash, Medi-Cal Update and on the HIPAA: Code Conversions Web page.