MLN006397 - Federally Qualified Health Center
This revised product comprises Subregulatory Guidance for the Federally Qualified Health Center, and its content is based on publicly available content at https://www.ssa.gov/OP_Home/ssact/title18/1861.htm#act-1861-aa,
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c13.pdf,
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c09.pdf, and https://www.congress.gov/117/bills/hr2617/BILLS-117hr2617enr.pdf#page=1440. CMS policy or operation subject matter experts also reviewed/cleared this product. This product educates Federally Qualified Health Centers (FQHCs) about billing and payment. This product also includes information on various FQHC topics such as who is considered an FQHC practitioners, Patient Services, Certification, Visits, Payments, Care Management Services, Flu & Pneumococcal Shots, COVID-19 Shots, & COVID-19 Monoclonal Antibody Therapies, Hepatitis B Shot Administration & Payment, Telehealth, Virtual Communication Services, and Consent for Care Management & Virtual Communication Services and includes links to applicable laws, regulations, and compliance information.
Revisions for this product include the following content updates:
• Added marriage and family therapists and mental health counselors as practitioners (page 4)
• Added services (pages 5, 9)
• Updates to mental health in-person visit rules (page 5)
• COVID-19 and other vaccine billing instructions (page 9)
The previous version of this Product is currently posted on CMS website at
https://www.cms.gov/files/document/mln006397-federally-qualified-health-center.pdf.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 18, 2023
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.