Centers for Medicare & Medicaid Services

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Content Section

Federally Qualified Health Centers (FQHC) Center

Spotlights
  • Try the NEW Guided Pathways (DEC2008) Medicare Learning Network (MLN) products! These three booklets incorporate existing Medicare Learning Network (MLN) products and other CMS resources into well organized sections that can help Medicare Fee-for-Service (FFS) providers and suppliers find information to understand and navigate the Medicare Program. The three Guided Pathways booklets guide learners to resources that provide a fundamental overview of Medicare knowledge, as well as detailed FFS policies and requirements. Click here to access the Guided Pathways educational web guide and booklets. (Posted 01/08/09)
  • 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
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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