Billing Requirements for FQHC and RHC Providers − Rendering Loop Change
Date: 06/25/25
Meridian would like to inform providers of rendering loop requirements for billing FQHC and RHCs services.
As of July 17, 2025, FQHC and RHC providers will be required to submit the HFS IMPACT registered rendering provider information on claims. This is necessary to properly apply benefits for FFS vs Encounter Rate claim adjudication.
Please follow these guidelines for submission:
Paper Claim CMS-1500 | HIPAA 5010 837P Loop | HIPAA 5010 837P Segment | Encounter Reimbursement |
|---|---|---|---|
Box 24b | 2300 | CLM05-1 | Place of Service Code |
Box 24f | 2400 | SV1-02 | Encounter rate on initial service line billed with appropriate code, modifier if applicable, and amount. All subsequent service lines with zero dollars, per Section F(ii) above. |
Box 24j | 2310B | NM1-09 | Site NPI or Registered Rendering Provider NPI* |
Box 31 | DOES NOT MAP IN THE 837 | DOES NOT MAP IN THE 837 | Signature of Physician |
Box 32 | 2310C | NM1 | Location where approved encounter service was provided |
Box 33 | 2010AA | NM108=XX | Registered Encounter Clinic Organization Name (not site), billing address, and NPI. Per X12 EDI guidance NO P.O. Boxes or LOCK box permitted in this loop (2010AA). |
2000A | PRV03 | Appropriate taxonomy for the registered provider specialty type in IMPACT:
| |
Pay to Provider | 2010AB | NM1*87 | Pay to Provider Address (P.O. Box or Lock Boxes acceptable in this loop) |
*NOTE: The IAMHP Comprehensive Billing Guidelines will be updated to add Meridian to the list of MCOs that REQUIRE the Registered Rendering Provider NPI. Do not use the SITE NPI for Meridian.
Beginning July 17, 2025, if your claim is submitted without the rendering provider details, your claim will be denied EXFd – Deny: FQHC/RHC Rendering Loop Verification – Must be Present**
For more information on billing requirements, please see the IAMHP Comprehensive Billing Manual.