What is a federally qualified health center?

Q: What is a federally qualified health center?

A Federally Qualified Health Center (FQHC) is a public health clinic that provides a wide range of primary and preventive care to populations that wouldn’t otherwise have adequate access to medical care.[efn_note]” Federally Qualified Health Center services ” Medicare.gov. Accessed June 1, 2025[/efn_note] FQHCs are regulated under Section 330 of the Public Health Service Act (PHS), certified by the Centers for Medicare and Medicaid Services (CMS), and receive enhanced reimbursement rates from the federal government.[efn_note]” Federally Qualified Health Centers (FQHCs) and the Health Center Program ” Rural Health Information Hub. Accessed June 1, 2025[/efn_note]

Q: Does Medicare cover care received in a Federally Qualified Health Center?

Yes, Medicare Part B covers care received in an FQHC,[efn_note]” Federally Qualified Health Center services ” Medicare.gov. Accessed June 1, 2025[/efn_note] and you will not have to pay the Part B deductible for care received in an FQHC. You will have to pay the Part B 20% coinsurance. Your coinsurance amount will be based on the lesser of the FQHC’s charge for the service or the adjusted prospective payment system (PPS) rate .[efn_note]” Medicare Claims Processing Manual, Chapter 9 – Rural Health Clinics/Federally Qualified Health Centers ” Centers for Medicare & Medicaid Services. Revised June 7, 2023[/efn_note]

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What is a federally qualified health center?

A Federally Qualified Health Center (FQHC) is a public health clinic that provides a wide range of primary and preventive care to populations that wouldn’t otherwise have adequate access to medical care.¹ FQHCs are regulated under Section 330 of the Public Health Service Act (PHS), certified by the Centers for Medicare and Medicaid Services (CMS), and receive enhanced reimbursement rates from the federal government.²

Does Medicare cover care received in a Federally Qualified Health Center?

Yes, Medicare Part B covers care received in an FQHC,¹ and you will not have to pay the Part B deductible for care received in an FQHC. You will have to pay the Part B 20% coinsurance. Your coinsurance amount will be based on the lesser of the FQHC’s charge for the service or the adjusted prospective payment system (PPS) rate.³

How can I find a Federally Qualified Health Center in my area?

You can use this search tool to find an FQHC in your area. There are almost 1,400 FQHCs in the United States. But there are also look-alike facilities and Federally Qualified Health Center Service Sites in far more locations.⁴

home and community based services (HCBS)

Home- and community-based services (HCBS) include a variety of medical and social services provided to individuals with functional or cognitive limitations. People who receive HCBS are able to continue living in the community – instead of entering a nursing home or another institutional setting. HCBS programs serve the needs of distinct groups of individuals, including people with physical disabilities, intellectual and developmental disabilities (IDD), and mental illnesses.

federally qualified health center

What is a federally qualified health center?

What is a federally qualified health center?

Does Medicare cover care received in a Federally Qualified Health Center?

How can I find a Federally Qualified Health Center in my area?

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home and community based services (HCBS)

home and community based services (HCBS)