Federally Qualified Health Center (FQHC) Medicaid Reimbursement

FQHC Medicaid Rates

FQHC Cost Reports Due Six-Months after Fiscal Year End

Cost reports for fiscal year end June 30, and any other month, are due six-months after the end of the fiscal year. As a reminder, cost reports for facilities with a FYE of June 30 are due December 31.

FQHC Cost Report & Reporting Guidelines

FQHC cost reports and accompanying information should be complete and accurately represent the provider's expenses for the cost reporting period in accordance with 42 CFR Parts 405, 491, and 493, and the allowable cost principles of the CMS Provider Reimbursement Manual (CMS Pub. 15-1). Providers receiving payment on the basis of reimbursable cost, must provide adequate data based on financial and statistical records which can be verified. Item 22 of the DSS Health Care Financing Provider Enrollment Agreement addresses making records and information available to DSS. A desk review will be performed on each FQHC cost report and based on the initial review of the cost report and the supporting schedules, a determination will be made regarding whether additional information is required. Additional documentation is due from the provider Thirty (30) days from date of request.

FQHC Rates and Profit/Loss Statements

FQHC Rate Letters  Effective 10/1/2021
FQHC Rate Letters  Effective 10/1/2022
FQHC Rate Letters  Effective 10/1/2023
FQHC Rate Letters Effective 10/1/2024
FQHC Rates Historic in Excel File
Regulation: Requirements for Payment to Federally Qualified Health Centers