Overview
Federally Qualified Health Centers (FQHCs) provide comprehensive health care services to underserved communities.
Methodology / Rules
The Federally Qualified Health Centers program rules are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 354, SubChapter A, Division 23, Rules 1321-1323.
Reimbursement rules applicable to the Federally Qualified Health Centers are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, SubChapter J, Division 14, Rule 8261.
Announcements
A survey for FQHCs is available until 9/15/2023. The survey allows FQHCs to opt-in to an alternative payment methodology (APM) based on an emergency State Plan Amendment approved by the Centers for Medicare and Medicaid Services (CMS) for the COVID-19 vaccine administration. This APM allows for the COVID-19 vaccine administration to be reimbursed outside of the prospective payment system (PPS) encounter rate when that is the only service provided on that date.
This APM was used to reimburse providers for vaccine only visits during the public health emergency. Agreement to the APM must be received based on requirements in the Medicaid State Plan. No reprocessing of claims or change in reimbursement is expected as a result of agreement.
Please visit the survey to complete it by 5:00PM on October 31, 2023. Any providers who fail to agree to the APM via the survey by 10/31/23 will have payments for COVID-19 vaccine only visits recouped.
Payment Rates
View the Federally Qualified Health Center Rates - Effective 04/01/2024 (.pdf)
View the Federally Qualified Health Center Rates - Effective 03/01/2024 (.pdf)
View the Federally Qualified Health Center Rates - Effective 02/01/2024 (.pdf)
View the Federally Qualified Health Center Rates - Effective 01/01/2024 (.pdf)
View the Federally Qualified Health Center Rates - Effective 12/15/2023 (.pdf)
View the Federally Qualified Health Center Rates - Effective 11/15/2023 (.pdf)
View the Federally Qualified Health Center Rates - Effective 10/13/2023 (.pdf)
View the Federally Qualified Health Center Rates - Effective 09/14/2023 (.pdf)
View the Federally Qualified Health Center Rates - Effective 08/14/2023 (.pdf)
View the Federally Qualified Health Center Rates - Effective 06/14/2023 (.pdf)
View the Federally Qualified Health Center Rates - Effective 05/12/2023 (.pdf)
View the Federally Qualified Health Center Rates - Effective 04/17/2023 (.pdf)
View the Federally Qualified Health Center Rates - Effective 03/15/2023 (.pdf)
View the Federally Qualified Health Center Rates - Effective 02/15/2023 (.pdf)
View the Federally Qualified Health Center Rates - Effective 01/13/2023 (.pdf)
View the Federally Qualified Health Center Rates - Effective 12/14/2022 (.pdf)
View the Federally Qualified Health Center Rates - Effective 11/14/2022 (.pdf)
View the Federally Qualified Health Center Rates - Effective 10/14/2022 (.pdf)
View the Federally Qualified Health Center Rates - Effective 09/01/2022 (.pdf)
View the Federally Qualified Health Center Rates - Effective 08/01/2022 (.pdf)
View the Federally Qualified Health Center Rates - Effective 07/01/2022 (.pdf)
View the Federally Qualified Health Center Rates - Effective 06/01/2022 (.pdf)
View the Federally Qualified Health Center Rates - Effective 05/01/2022 (.pdf)
View the Federally Qualified Health Center Rates - Effective 04/01/2022 (.pdf)
View the Federally Qualified Health Center Rates - Effective 03/01/2022 (.pdf)
View the Federally Qualified Health Center Rates - Effective 02/01/2022 (.pdf)
View the Federally Qualified Health Center Rates - Effective 01/01/2022 (.pdf)
View the Federally Qualified Health Center Rates - Effective 12/01/2021 (.pdf)
View the Federally Qualified Health Center Rates - Effective 11/01/2021 (.pdf)
View the Federally Qualified Health Center Rates - Effective 10/01/2021 (.pdf)
View the Federally Qualified Health Center Rates - Effective 09/01/2021 (.pdf)
View the Federally Qualified Health Center Rates - Effective 08/01/2021 (.pdf)
View the Federally Qualified Health Center Rates - Effective 07/01/2021 (.pdf)
View the Federally Qualified Health Center Rates - Effective 06/01/2021 (.pdf)
View the Federally Qualified Health Center Rates - Effective 05/01/2021 (.pdf)
View the Federally Qualified Health Center Rates - Effective 04/01/2021 (.pdf)
View the Federally Qualified Health Center Rates - Effective 03/01/2021 (.pdf)
View the Federally Qualified Health Center Rates - Effective 02/01/2021 (.pdf)
View the Federally Qualified Health Center Rates - Effective 01/01/2021 (.pdf)
View the Federally Qualified Health Center Rates - Effective 12/01/2020 (.pdf)
View the Federally Qualified Health Center Rates - Effective 11/01/2020 (.pdf)(updated 12/04/2020)
View the Federally Qualified Health Center Rates - Effective 10/01/2020 (.pdf)(updated 12/04/2020)
View the Federally Qualified Health Center Rates - Effective 09/01/2020 (.pdf)(updated 12/04/2020)
View the Federally Qualified Health Center Rates - Effective 08/01/2020 (.pdf)(updated 12/04/2020)
View the Federally Qualified Health Center Rates - Effective 07/01/2020 (.pdf)
View the Federally Qualified Health Center Rates - Effective 06/01/2020 (.pdf)
View the Federally Qualified Health Center Rates - Effective 05/01/2020 (.pdf)
View the Federally Qualified Health Center Rates - Effective 04/01/2020 (.pdf)
View the Federally Qualified Health Center Rates - Effective 03/01/2020 (.pdf)
View the Federally Qualified Health Center Rates - Effective 02/01/2020 (.pdf)
View the Federally Qualified Health Center Rates - Effective 01/01/2020 (.pdf)
View the Federally Qualified Health Center Rates - Effective 12/01/2019 (.pdf)
View the Federally Qualified Health Center Rates - Effective 11/01/2019 (.pdf)
View the Federally Qualified Health Center Rates - Effective 10/01/2019 (.pdf)
View the Federally Qualified Health Center Rates - Effective 09/01/2019 (.pdf)
View the Federally Qualified Health Center Rates - Effective 08/01/2019 (.pdf)
View the Federally Qualified Health Center Rates - Effective 07/01/2019 (.pdf)
View the Federally Qualified Health Center Rates - Effective 06/01/2019 (.pdf)
View the Federally Qualified Health Center Rates - Effective 05/01/2019 (.pdf)
View the Federally Qualified Health Center Rates - Effective 04/01/2019 (.pdf)
View the Federally Qualified Health Center Rates - Effective 03/01/2019 (.pdf)
View the Federally Qualified Health Center Rates - Effective 02/01/2019 (.pdf)
View the Federally Qualified Health Center Rates - Effective 01/01/2019 (.pdf)
View the Federally Qualified Health Center Rates - Effective 12/01/2018 (.pdf)
View the Federally Qualified Health Center Rates - Effective 11/01/2018 (.pdf)
View the Federally Qualified Health Center Rates - Effective 10/01/2018 (.pdf)
View the Federally Qualified Health Center Rates - Effective 09/01/2018 (.pdf)
View the Federally Qualified Health Center Rates - Effective 08/01/2018 (.pdf)
View the Federally Qualified Health Center Rates - Effective 07/01/2018 (.pdf)
View the Federally Qualified Health Center Rates - Effective 06/01/2018 (.pdf)
View the Federally Qualified Health Center Rates - Effective 05/01/2018 (.pdf)
View the Federally Qualified Health Center Rates - Effective 04/01/2018 (.pdf)
View the Federally Qualified Health Center Rates - Effective 03/01/2018 (.pdf)
View the Federally Qualified Health Center Rates - Effective 02/01/2018 (.pdf)
View the Federally Qualified Health Center Rates - Effective 01/01/2018 (.pdf)
View the Federally Qualified Health Center Rates - Effective 12/01/2017 (.pdf)
View the Federally Qualified Health Center Rates - Effective 11/01/2017 (.pdf)
View the Federally Qualified Health Center Rates - Effective 09/01/2017 (.pdf)
View the Federally Qualified Health Center Rates - Effective 06/01/2017 (.pdf)