R13618OTN

Transmittal #
R13618OTN
Issue Date
2026-02-05
Subject

Update to the Payment for Historically Excepted Tribal Federally Qualified Health Centers (FQHCs) for Calendar Year (CY) 2026

Implementation Date
2026-03-06
CR #
14349
Provider Education
MLN Connects Newsletter Message
Provider Education Release Date
2026-02-19
Publication #
100-20
Transmittal Year
2026

MLN Connects® Newsletter Message

Historically Excepted Tribal Federally Qualified Health Centers: CY 2026 Payment Rate 

The CY 2026 historically excepted (previously called grandfathered) tribal Federally Qualified Health Center Prospective Payment System rate is $733 for medically necessary face-to-face visits.

CMS will adjust CY 2026 claims paid at the CY 2025 rate. You don’t need to take any action.

See the instruction to your Medicare Administrative Contractor (PDF). 

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