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.
