LABORATORY

 All Independent RHC lab services are billed to Medicare Part B using the clinic Medicare Part B number and filed in the 1500 claim format. 

 All Provider Based RHC lab services are billed to Medicare Part A using the hospital Medicare Part A number and filed in the UB 04 format. 

 This includes venipuncture. 

 Use CLIA waived modifiers QW on Part B claims.

MEDICARE EKG

 The professional component (interp and report) 93010 is bundled into the RHC encounter and billed inclusive on the UB form to Medicare Part A. 

 The technical component 93005 is billed as fee for service to Medicare Part B using the clinic Medicare Part B number

RADIOLOGY

 The professional component is bundled into the RHC encounter. 

 Know if the professional piece is contracted by a radiologist not included in the RHC. 

 Know if the contracted radiologist is billing for the reading. 

 For Independent RHC the technical component is billed as fee for service to Medicare Part B on a 1500 claim form using the clinic Medicare Part B number. 

 For Provider Based RHC the technical component is billed on the Main Provider Part A UB form.

INJECTIONS

 Injections and immunizations are only billed to Medicare and Medicare HMOs if there is a valid faceto-face encounter with an approved provider. 

 If you have a face-to-face encounter within 30 days prior or after the date of the injection/immunization, your may bundle the injection/immunization service into the encounter and bill to Medicare and Medicare HMOs.