G0469 HCPCS - FEDERALLY QUALIFIED HEALTH CENTER (FQHC) VISIT, MENTAL HEALTH, NEW PATIENT; A MEDICALLY-NECESSARY, FACE-TO-FACE MENTAL HEALTH ENCOUNTER (ONE-ON-ONE) BETWEEN A NEW PATIENT AND A FQHC PRACTITIONER DURING WHICH TIME ONE OR MORE FQHC SERVICES ARE RENDERED AND INCLUDES A TYPICAL BUNDLE OF MEDICARE-COVERED SERVICES THAT WOULD BE FURNISHED PER DIEM TO A PATIENT RECEIVING A MENTAL HEALTH VISIT

Code Information

  • HCPCS Code: G0469
  • Sequence Number: 0010
  • Short Description: Fqhc visit, mh new pt
  • Long Description: Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit
  • Date Added: 10/1/2014
  • Action Code: N - No maintenance for this code
  • Action Effective Date: 10/1/2014
  • Classification: Temporary Procedures & Professional Services
  • Coding System: HCPCS

Code Type

  • Berenson-Eggers Type Of Service Code: M1A - Office visits - new
  • Type Of Service Code:
    • 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96

Billing Information

  • Pricing Indicator Code:
    • 13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)
  • Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
  • Coverage Issues Manual Reference Section Number:
      N/A
    • Medicare Carriers Manual Reference Section Number:
        N/A
      • Coverage Code: C - Carrier judgment

      HCPCS Record

      Field Name Field Value
      Healthcare Common Procedure Coding System Code G0469
      HCPCS Sequence Number 0010
      HCPCS Record Identification Code 3 - First line of procedure record also contains detail information in positions 92-275
      HCPCS Long Description Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit
      HCPCS Short Description Fqhc visit, mh new pt
      HCPCS Pricing Indicator Code 1 13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)
      HCPCS Multiple Pricing Indicator Code A - Not applicable as HCPCS priced under one methodology
      HCPCS Coverage Code C - Carrier judgment
      HCPCS Berenson-Eggers Type Of Service Code M1A - Office visits - new
      HCPCS Type Of Service Code 1 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96
      HCPCS Anesthesia Base Unit Quantity 0
      HCPCS Code Added Date 10/1/2014
      HCPCS Action Effective Date 10/1/2014
      HCPCS Action Code N - No maintenance for this code

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      This page was last updated on: 7/1/2024