Question 1

What is HCPCS code G0470?

Accepted Answer

HCPCS code G0470 is "Fqhc visit, mh estab pt". Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established 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

Question 2

What category is G0470 in?

Accepted Answer

G0470 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0470?

Accepted Answer

Use G0470 when billing for fqhc visit, mh estab pt. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is G0470 covered by Medicare?

Accepted Answer

Coverage for G0470 (Fqhc visit, mh estab pt) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for G0470?

Accepted Answer

Documentation for G0470 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).