Centers for Medicare & Medicaid Services

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Content Section

Federally Qualified Health Centers (FQHC) Center

Spotlights
  • CMS-1910-P2 [PDF & HTML] - Changes in Conditions of Participation Requirements and Payment Provisions for Rural Health Clinics and Federally Qualified Health Centers; Proposed Rule {Published June 27, 2008; Comments due by 5 p.m. on August 26, 2008}; View Press Release and Fact Sheet.

Medicare Learning Network (MLN) Spotlights

Go to the What's New page for the latest MLN products and announcements!  Check it often!


Important Links


Billing / Payment
  • HIPAA Information for Medicare Providers
  • HIPAA Information for Medicare and Non-Medicare Providers

Policies/Regulations
  • Medicare Modernization Update 
  • Quarterly Provider Update
  • Health Insurance Portability and Accountability Act (HIPAA)
  • National Provider Identifier (NPI)

Enrollment/ Participation/ Certification
  • Medicare Enrollment
  • Enrollment Applications
  • Conditions for Coverage (CfCs) and Conditions of Participation (CoPs) and - Overview 
  • CfC and CoP: Rural Health Clinic/Federally Qualified Health Centers
  • Survey and Certification

Medicare Prescription Drug Coverage
  • Information for Providers

National Provider Identifier (NPI)
  • Information for Medicare Fee-for-Service Providers about the NPI

Medicare Secondary Payer
  • Medicare Secondary Payer and You
  • Medicare Secondary Payer Manual
  • Coordination of Benefits

Education
  • Medicare Learning Network (MLN)
  • MLN Educational Web Guides
  • MLN Matters Articles (Search)
  • MLN Products

How to Stay Informed
  • Open Door Forum
  • Press Releases
  • Mailing Lists -- Sign up for the FQHC mailing list!

Helpful Links
  • Rural Health Center
  • Rural Assistance Center (for FQHC)

 

CMS Manuals & Transmittals
  • CMS Manuals
  • CMS Internet-only Manuals
  • Transmittals
  • Medicare Claims Processing Manual: Chapter 9 -  Rural Health Clinics/ Federally Qualified Health Centers
  • Medicare Benefit Policy Manual: Chapter 13 - Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services
  • The Medicare Rural Health Clinic and Federally Qualified Health Center Manual Paper-Based Manual
  • State Medicaid Manual:  Payment for Services: State Plan Amendments [PDF, 517KB, pages 6-51]
  • Provider Reimbursement Manual Chapter 29-(T7) -- Independent Rural Health Clinic and Freestanding Federally Qualified Health Center cost Report Form HCFA 222-92 (Instructions) Paper-Based Manual [ZIP, 56KB]
  • Medicare Secondary Payer Manual
  • Medicare National Coverage Determinations Manual
  • To receive changes to the CMS Quarterly Provider Update, subscribe to the CMS-QPU Listserv from the CMS Mailing Lists Page.

Coding
  • Healthcare Common Procedure Coding System (HCPCS) 
  • Alpha-Numeric HCPCS File
  • ICD-9-CM -- General Information
  • ICD-9 -- Codes
  • Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs)

Coverage
  • Medicare Coverage
  • Medicare Coverage Database
  • Medicare National Coverage Determinations Manual

Medical Review/ Fraud & Abuse
  • Medical Review Process
  • Beneficiary Complaint Response Program
  • Physician Self Referral

Resources
  • Critical Access Hospital Center
  • Therapy Services
  • Medicaid Information
  • Partnering with CMS Center
  • Rural Health Center
  • Telehealth

Medicare Fee-for-Service Part B Drugs
  • Competitive Acquisition Program for Part B Drugs & Biologicals
  • Historical Part B Drug Pricing Files
  • Medicare Part B Drugs Average Sales Price

Publications
  • Medicaid: 35 Years of Service
  • MLN Products FQHC

Contacts
  • Contact Your Carrier/FI via Toll-Free Numbers and Websites -- A listing of the toll-free numbers that CMS has installed at Medicare FFS contractor sites.
  • Quality Improvement Organizations (QIO)
  • CMS Regional Offices
  • Contacting the Coordination of Benefits Contractors  (COBC)

 

Browse by Special Topic

  • American Indian/Alaska Native Center
  • End Stage Renal Disease (ESRD) Center
  • Legislative Affairs Center
  • Medicare Coverage Center
  • Newsroom Center
  • Ombudsman Center
  • Open Enrollment Center
  • Partnering with CMS Center
  • People With Medicare & Medicaid Center
  • Quality of Care Center
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