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FQHC/RHC/IHS-MOA Code Conversion Reminder

December 1, 2017

Effective for dates of service on or after October 1, 2017, the FQHC/RHC/IHS-MOA code conversion established 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 replaced local codes previously used 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 heading:

Note:

Code sets listed in these crosswalks are billable as of October 1, 2017.

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