CMS Extends G0511 Billing for Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) until September 30, 2025

FQHCs and RHCs may continue billing HCPCS code G0511 (General Care Management Services) through September 30, 2025, if more time is needed to update billing systems. Providers already billing individual HCPCS or CPT codes with applicable add-on codes for care coordination should continue doing so. Facilities must choose one billing method and apply it consistently through September 30, 2025. G0511 may be billed multiple times per month if all program requirements are met and no double counting occurs. These services may be billed alone or with other payable services. Payment is made under the Physician Fee Schedule (PFS) with FQHC patients paying 20 percent coinsurance and RHC patients paying a deductible and 20 percent coinsurance.

G0511 is comprised of the following services:

  • Chronic Care Management (CCM) - 99487, 99490, 99491 (Add-on codes: 99437, 99439, 99489)
  • Principal Care Management (PCM) - 99424, 99426 (Add-on codes: 99425, 99427)
  • Chronic Pain Management (CPM) - G3002 (Add-on code: G3003)
  • General Behavioral Health Integration (BHI) - 99484, G0323 (Add-on code: N/A)
  • Remote Physiological Monitoring (RPM) - 99091, 99453, 99454, 99457, 99474 (Add-on code: 99458)
  • Remote Therapeutic Monitoring (RTM) - 98975, 98976, 98977, 98980 (Add-on code: 98981)
  • Community Health Integration (CHI) - G0019 (Add-on code: G0022)
  • Principal Illness Navigation (PIN) - G0023 (Add-on code: G0024)
  • Principal Illness Navigation - Peer Support (PIN-PS) - G0140 (Add-on code: G0146)
  • Advanced Primary Care Management (APCM) - G0556, G0557, G0558 (Add-on code: N/A)

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