
<oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
  <dc:title>Same-day billing for medical and mental health services at FQHCs : estimating the fiscal impact</dc:title>
  <dc:title>Issue brief (California HealthCare Foundation)</dc:title>
  <dc:creator>Degenfelder, Curt, author.</dc:creator>
  <dc:subject>Mental Health Services -- economics</dc:subject>
  <dc:subject>Prospective Payment System</dc:subject>
  <dc:description>This issue brief provides an analysis of the fiscal impact in California of same-day billing for medical and mental health services in Federally Qualified Health Centers (FQHCs). FQHCs are paid by Medi-Cal under the Prospective Payment System (PPS). In California, each licensed clinical site (clinic site) has its own PPS rate, with a fixed per-visit dollar amount payment rate for qualifying visits. These rates are increased by the Medicare Economic Index (MEI) each year. FQHCs may also apply for a rate change through the Medi-Cal Change in Scope-of- Service Request process. Currently, while FQHCs may render both medical and mental health services on the same day to Medi-Cal patients, they cannot be reimbursed for both visits. California has considered several proposals to allow FQHCs to bill a medical visit and a mental health visit that take place on the same day at a single location as separate visits, referred to as &quot;same-day billing.&quot; The analysis that follows estimates the impact of a policy change to allow same-day billing both without (Scenario 1) and with (Scenario 2) a requirement that FQHCs apply for a change in scope in order to have the option of billing for same-day visits for mental health. The analysis is not specific to a particular current or past proposal. The analysis provides an estimate of the annual impact of the two scenarios on both Medi-Cal mental health visits and Medi-Cal reimbursement costs.</dc:description>
  <dc:publisher>[Oakland, California] : California Health Care Foundation, April 2020</dc:publisher>
  <dc:contributor>California HealthCare Foundation, issuing body.</dc:contributor>
  <dc:type>Technical Report</dc:type>
  <dc:format>Text</dc:format>
  <dc:format>1 online resource (1 PDF file (5 pages)).</dc:format>
  <dc:identifier>nlm:nlmuid-101771813-pdf</dc:identifier>
  <dc:identifier>101771813</dc:identifier>
  <dc:identifier>http://resource.nlm.nih.gov/101771813</dc:identifier>
  <dc:language>English</dc:language>
  <dc:coverage>United States</dc:coverage>
  <dc:rights>Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. https://creativecommons.org/licenses/by-nc-nd/3.0</dc:rights>
</oai_dc:dc>