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Review of the New Medicare PPS for Federally Qualified Health Centers
Federally Qualified Health Centers

As required by Section 10501 of the Affordable Care Act, Federally Qualified Health Centers (FQHCs) will transition to a prospective payment system (PPS) beginning on October 1, 2014. Medicare payment will be based on the PPS rate or the total charges, whichever is less, with adjustments for geographic location, new patient visits, initial Medicare visits, and annual wellness visits. In developing the Medicare FQHC PPS, the statute requires CMS to take into account the type, intensity, and duration of FQHC services and allows other adjustments, such as geographic adjustments. Initial payments (Medicare and coinsurance) must equal 100 percent of reasonable costs, as determined without application of the current system's per visit payment limits and adjustments that can reduce an FQHC's per visit rate. This MLN Connects™ National Provider Call will describe the final policies for the new Medicare PPS for FQHCs.

When: Wednesday, May 21, 2014

Time:   12:30 PM - 2:00 PM Eastern Time

Target Audience: FQHCs and other interested stakeholders.


  • Review of the requirements of the Affordable Care Act for a new Medicare PPS for FQHCs
  • Proposed policies, comments, and final provisions of the new FQHC PPS
  • Resources for more information
  • Question & Answer

Call Materials: 
Presentation [PDF, 312KB]

MLN Matters Article #MM8743 [PDF, 101KB]

Audio Recording [ZIP, 18MB]

Written Transcript [PDF, 485KB]

To register for an MLN Connects National Provider Call, please visit the CMS MLN Connects Upcoming Calls registration website.

Registration Assistance:

For More Information:
Visit the Federally Qualified Health Center PPS web page for more information.