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The fastest growing health plan in Michigan

We're a nationally recognized nonprofit health benefits company focused on improving the health and lives of one million members across Michigan.

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Priority Health Medicare & Medigap plans

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Helping Michiganders manage mental health

New virtual care billing requirement now in place for FQHCs and RHCs

We identified an error in our Federally Qualified Health Clinics (FQHCs) and Rural Health Clinics (RHCs) set up for telehealth/virtual behavioral health services. This resulted in us overpaying for these services, above the Centers for Medicare & Medicaid Services (CMS) approved rate.

We’ve updated our systems and now require FQHC and RHC providers to use the new G codes for telehealth/virtual behavioral health services.

Telehealth/Virtual services: bill the G code with the appropriate revenue code (0529-0592)
Telehealth/Virtual behavioral health services: bill the G code with revenue code 0900

We’ll automatically reprocess any impacted claims submitted between 5/1/21 and 4/21/22, adjusting payments according to our corrections to payments policy.

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