G0511 HCPCS - RURAL HEALTH CLINIC OR FEDERALLY QUALIFIED HEALTH CENTER (RHC OR FQHC) ONLY, GENERAL CARE MANAGEMENT, 20 MINUTES OR MORE OF CLINICAL STAFF TIME FOR CHRONIC CARE MANAGEMENT SERVICES OR BEHAVIORAL HEALTH INTEGRATION SERVICES DIRECTED BY AN RHC OR FQHC PRACTITIONER (PHYSICIAN, NP, PA, OR CNM), PER CALENDAR MONTH

Code Information

HCPCS Code: G0511

Sequence Number: 0010

Short Description: Ccm/bhi by rhc/fqhc 20min mo

Long Description: Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month

Code Added Date: 1/1/2018

Action Code: A - Add procedure or modifier code

Action Effective Date: 1/1/2018

Classification: Temporary Procedures & Professional Services

Coding System: HCPCS

Code Type

Berenson-Eggers Type Of Service Code: M5D - Specialist - other
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: D - Special coverage instructions apply

      HCPCS Record

      Field Name Field Value
      Healthcare Common Procedure Coding System Code G0511
      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 Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month
      HCPCS Short Description Ccm/bhi by rhc/fqhc 20min mo
      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 D - Special coverage instructions apply
      HCPCS Processing Note Number 0214
      HCPCS Berenson-Eggers Type Of Service Code M5D - Specialist - other
      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 1/1/2018
      HCPCS Action Effective Date 1/1/2018
      HCPCS Action Code A - Add procedure or modifier code

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      This page was last updated on: 1/1/2018