Federally Qualified Health Centers (FQHC) Center

Billing / Payment

• Electronic Billing & EDI Transactions
• HIPAA - General Information

Policies/Regulations

• Quarterly Provider Updates
• HIPAA - General Information
• National Provider Identifier Standard (NPI)

Enrollment/ Participation/ Certification

• Medicare Provider-Supplier Enrollment
• Enrollment Applications
• Conditions for Coverage (CfCs) & Conditions of Participations (CoPs)
• CfC and CoP: Rural Health Clinic/Federally Qualified Health Center
• Survey & Certification - General Information
• National Provider Identifier Standard (NPI)

Medicare Secondary Payer

• Medicare Secondary Payer & You
• Internet-Only Manuals (IOMs)
• Coordination of Benefits - General Information

Education

• MLN General Information
• MLN Educational Web Guides
• MLN Matters Articles  ( Search Tips )
• MLN Products

How to Stay Informed

• Subscribe now to receive the weekly CMS Medicare FFS Provider e-News for the latest Fee-For-Service program information, event announcements, claims and pricer information, and MLN educational product updates.
• Open Door Forums
• Press Releases - Opens in a new window

Helpful Links

• Rural Health Clinics Center
• Rural Assistance Center (for FQHC) - Opens in a new window

CMS Manuals & Transmittals

• Manuals
• Internet-Only Manuals (IOMs)
• Transmittals
• Medicare Claims Processing Manual: Chapter 9 - Rural Health Clinics/Federally Qualified Health Centers [PDF, 215KB]
• Medicare Benefit Policy Manual: Chapter 13 - Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services [PDF, 208KB]
• The Medicare Rural Health Clinic and Federally Qualified Health Center Manual Paper-Based Manual
• State Medicaid Manual: Payment for Services: State Plan Amendments (pages 6-51)
• Provider Reimbursement Manual: Chapter 29-(T10) -- Independent Rural Health Clinic and Freestanding Federally Qualified Health Center cost Report Form CMS 222-92 (Instructions) [ZIP, 172KB] Paper-Based Manual
• 100-05 Medicare Secondary Payer Manual
• National Coverage Determinations (NCD) Manual - Pub. 100-03
• To receive changes to the CMS Quarterly Provider Update, subscribe to the CMS-QPU Listserv from the CMS Mailing Lists Page.

Coding

• HCPCS - General Information
• Alpha-Numeric HCPCS
• ICD-9-CM
• New, Deleted, and Revised ICD-9-CM Codes - Summary Tables
• Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs) - Opens in a new window

Coverage

• Medicare Coverage - General Information
• Medicare Coverage Database - Opens in a new window
• National Coverage Determinations (NCD) Manual - Pub. 100-03

Medical Review/ Fraud & Abuse

• Beneficiary Complaint Response Program
• Physician Self Referral

Resources

• Critical Access Hospitals Center
• Therapy Services
• Medicaid Information - Opens in a new window
• Partnering with CMS Center
• Rural Health Clinics Center
• Telehealth

Medicare Fee-for-Service Part B Drugs

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

Publications

• MLN Products
• MLN Publications - Search for "Federally Qualified Health Center"

Contacts

• CMS Regional Offices
• CMS Regional Office Rural Health Coordinators Updated January 2013 [PDF, 25KB]
• Coordination of Benefits - General Information