Federally Qualified Health Centers
Federally Qualified Health Centers (FQHC) establish a set of health care services for Medicaid customers, offering core services or other ambulatory services. FQHCs were added to the Medicaid program through a Social Security Act amendment, Section 6404 of Public Law 100-203.
Financial Information
Core Billing Rates
To establish and maintain rates for FQHC providers, the following documents must be submitted to NC Medicaid by mail or fax:
- Enrollment letters from the Centers for Medicare and Medicaid Services (CMS)
- Enrollment letters from NC Medicaid Provider Enrollment
- Initial and annually updated fiscal intermediary rate letters
Change in Scope of Services
- Change in Scope of Service Policy
- CISS form for CMS222-92
- CISS form for CMS224-14
- CISS form instructions
Contact
Layth Salman
Phone: 919-527-7684
Fax: 919-831-1811
Email: layth.salman@dhhs.nc.gov
Mailing Address
2501 Mail Service Center
Raleigh NC 27699-2501
NC Medicaid Clinical Section
Phone: 919-855-4260
Fax: 919-733-2796