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Let’s get to know about FQHC today! We have all heard about FQHC & RHC and how different they are from the other clinics. FQHC & RHC are two separate type of clinics with different requirements. Today, we will take a look at FQHC, about it’s inception and requirements.

What is an FQHC?

A Federally Qualified Health Center (FQHC) is a reimbursement designation from the Bureau of Primary Health Care and the Centers of Medicare and Medicaid Services of the United States Department of Health and Human Services.

FQHCs are safety net providers that provide services typically given in a clinic. FQHCs include:

    • Community health centers
    • Migrant health centers
    • Health care for the homeless health centers
    • Public housing primary care centers
    • Health center program “look-alike”
    • Outpatient health programs or facilities operated by a tribe or tribal organization or by an urban Indian organization

Some background about FQHC…

The FQHC program was an extension of the Community/Migrant Health Center programs enacted in the 1960 and 1970s. The original CHC/MHC programs provided Federal grants to CHCs or MHCs for the care of uninsured individuals. These facilities received no special Medicare and Medicaid payments. Congress created the FQHC program to allow special Medicare and Medicaid payments for CHCs and MHCs thereby ensuring that grant dollars intended for the uninsured were available for that purpose. The FQHC program provides for cost-based reimbursement under Medicare and Medicaid for legislatively specified services.

Let’s see how is it different from RHC!

  1. FQHC serves both urban and rural areas, whereas, an RHC are only situated in rural areas.
  2. FQHC provides care in both MUAs (Medically Underserved Areas) and MUPs (Medically Undeserved Populations). RHC provides care only in HPSA (Health Professional Shortage Areas) or MUAs (Medically Underserved Areas)
  3. An FQHC provides wider rage of healthcare services like labs and diagnostics, pharmaceutical, behavioral, oral, hospital and specialty, after hours care, transportation and interpretative services. An RHC clinic provider just the primary out-patient care, basic lab services and emergency care.
  4. FQHC’s are eligible for federal funding whereas, RHC’s do not receive federal funding.
  5. FQHC’s are required to treat all residents in their service area which charges based on the sliding fee scale. Whereas, RHC’s are not required to charge on a sliding fee schedule.

So now we have some basic understanding about FQHC, on our next blog, let’s look at the billing specifics… Meanwhile if you have any questions or would like to know how Total RCM Solutions can help, feel free to leave a comment below or contact us.

Thanks for reading and have a great day!

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