A claim processing issue has been identified that potentially impacts all Cohort 1 Primary Care First (PCF) participants that submitted claims for flat visit fee (FVF) eligible services processed between January 1, 2021, and February 3, 2021.
During the public health emergency, CMS amended regulations to remove the requirement that certain diagnostic tests are covered only when ordered by the treating physician. Additional codes have been added that do not require an ordering provider on the claim.
First Coast has updated the status indicator and payment rates for HCPCS code Q5122.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.