HCPCS Code G0468: Federally Qualified Health Center (FQHC) Visit, IPPE or AWV

FQHC billing for G0468 made simple. Read our guide to know what to document, how to bill with IPPE/AWV, and which modifiers to use.

Use Code

Frequently asked questions

No. For an IPPE or AWV, FQHCs should only report G0468 for payment. The codes G0402, G0438, and G0439 are for non-FQHC settings and should not be billed on the same claim as G0468. The qualifying code should be used internally for documentation purposes only.

Yes. You may separately report medically necessary services such as labs or problem-oriented E/M when furnished on the same date of service, consistent with FQHC rules. Coinsurance can apply to those additional services, while G0468 remains fully covered.

Yes. Under the PPS methodology, G0468 is paid at an enhanced rate for preventive services, often described as approximately 34.16 percent above the base PPS encounter rate. The exact payment depends on your geographic adjustments and current CMS guidance.