MM14309 - Federally Qualified Health Center & Intensive Outpatient Program Payment Rates: CY 2026 Update
Section 1834(o) of the Social Security Act established the FQHC PPS under Medicare Part B. Under the FQHC PPS, Medicare pays FQHCs based on the lesser of their actual charges or the PPS rate for all FQHC services you provide to a patient on the same day as a medically necessary face-to-face visit. We increase the FQHC PPS base payment rate annually by the FQHC market basket percentage.
We adjust the FQHC PPS base rate for each FQHC by the FQHC geographic adjustment factor (GAF). We adapt the FQHC GAF from the work and practice expense geographic practice cost indices in the Physician Fee Schedule.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: December 08, 2025
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