Clinic/Center-Federally Qualified Health Center (FQHC)
Bill the encounter using procedure code T1015 with the appropriate rate on the first detail line. Providers are required to list all the CPT/HCPCS services provided during the encounter priced at zero dollars on subsequent lines. CPT codes included with the T1015 encounter code must accurately indicate the service(s) provided during the encounter and conform to National Correct Coding Initiative (NCCI) standards. Claims submitted without the corresponding CPT/HCPCS codes will be denied.
Service HCPCS Diagnosis Description Modifier Place of Service
Clinic/ Center -FQHC T1015 Use appropriate diagnosis code for services rendered. (i.e., Well Child Exam, Family Planning) All FQHC clinics must use procedure code T1015 for medical services. 76 (same day/ same provider) 77 (same day/ different provider) 50
Clinic/Center-Rural Health Clinics (RHC)
Bill the encounter using procedure code T1015 with the appropriate rate on the first detail line. Providers are required to list all the CPT/HCPCS services provided during the encounter priced at zero dollars on subsequent lines. CPT codes included with the T1015 encounter code must accurately indicate the service(s) provided during the encounter and conform to National Correct Coding Initiative (NCCI) standards. Claims submitted without the corresponding CPT/HCPCS codes will be denied.
Service HCPCS Diagnosis Description Modifier Place of Service
Clinic/ Center -Rural Health Clinics T1015 Use appropriate diagnosis code for services rendered. (i.e., Well Child Exam, Family Planning) All rural health clinics must use procedure code T1015 for medical services. 76 (same day/ same provider) 77 (same day/ different provider) 72
Indian Health Center (IHC)
Bill the encounter using procedure code T1015 with the appropriate rate on the first detail line. Providers are required to list all the CPT/HCPCS services provided during the encounter priced at zero dollars on subsequent lines. CPT codes included with the T1015 encounter code must accurately indicate the service(s) provided during the encounter and conform to National Correct Coding Initiative (NCCI) standards. Claims submitted without the corresponding CPT/HCPCS codes will be
denied.
Service HCPCS Diagnosis Description Modifier Place of Service
Clinic/ Center -Indian Health Clinics T1015 Use appropriate diagnosis code for services rendered. (i.e., Well Child Exam, Family Planning) All rural health clinics must use procedure code T1015 for medical services. 76 (same day/ same provider) 77 (same day/ different provider) 5
