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.

• Fee Schedules
• Clinical Coverage Policy 1D-4, Core Services Provided in Federally Qualified Health Centers and Rural Health Clinics

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

Provider Reimbursement Team 
Phone: (984) 304 2260
Fax: (919) 831-1811
Email: Medicaid.ProviderReimbursement@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