Question 1

What is HCPCS code G0511?

Accepted Answer

HCPCS code G0511 is "Ccm/bhi by rhc/fqhc 20min mo". 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

Question 2

What category is G0511 in?

Accepted Answer

G0511 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0511?

Accepted Answer

Use G0511 when billing for ccm/bhi by rhc/fqhc 20min mo. 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 G0511 covered by Medicare?

Accepted Answer

Coverage for G0511 (Ccm/bhi by rhc/fqhc 20min mo) 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 G0511?

Accepted Answer

Documentation for G0511 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).