NYS Family Planning Billing Refresher

NYS Family Planning Billing Refresher

New York State Family Planning Training Center



Best Practices and Common Mistakes April 30, 2020

Last 1Updated March 2018

Presenter

New York State Family Planning Training Center



Ann Finn

518.522.8159 ann@ A NYS and NYC certified Women Owned Business (WBE)

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Teamwork

New York State Family Planning Training Center



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Reimbursement ? Coding Matters

New York State Family Planning Training Center



? NYS Medicaid Article 28/FQHC:

? Ambulatory Patients Groups (APG) payment system

? Medicaid Managed Care plans often pay under APGs ? Dependent on CPT, modifier and diagnosis coding

? Prospective Payment System (PPS)

? Facility threshold visit rate for FQHCs that don't opt in to APGs

? Other TPP payers:

? Per contract ? typically by CPT code

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? Provider Manuals, Fee Schedules, Medicaid Updates, and Other Guidance

? ProviderMa nuals/index.asp

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New York State Family Planning Training Center



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