Supplemental Payment Submission Forms-Max Entries [366KB MS Excel] Posted March 2, 2020; Prospective Payment System for FQHCs and RHCs [258KB PDF] Posted July 31, 2014; 2020. Federally Qualified Health Centers . See how Medicare can help pay costs for preventive services at approved FQHCs. FQHCs can expect the payment to be slightly higher or lower depending on the GAF/GPCI. Select a State or Territory and click the “Submit” button. 1 . FQHCs can expect the payment to be slightly higher or lower depending on the GAF/GPCI. HRSA programs provide health care to people who are geographically isolated, economically or medically vulnerable. • 0527 - FQHC Visiting Nurse Service(s) to a member’s home when in a home health shortage area • 0528 - Visit by a FQHC practitioner to other non FQHC site (e.g., scene of accident) • 0900 - Behavioral Health Treatment Revenue Codes Notes: Rates here are based on the 2020 Medicare Physician Fee Schedule (PFS); no Geographical Adjustment Factor (GAF) or Geographic Practice Cost Index (GPCI) has been applied. CR 11500 informs MACs about updates to the Prospective Payment System (PPS) base payment rate and the Geographic Adjustment Factors (GAFs) for the Federally Qualified Health Center (FQHC) Pricer. G2012 ($14.80). FQHCs and LALs by State Federally Qualified Health Centers and Look-Alikes. Effective Date: January 1, 2020 Implementation Date: January 6, 2020. • $173.50 and $232.77 are the FQHC unadjusted CMS PPS rate ceilings Looking for Federally Qualified Health Center (FQHC) services coverage? January 1, 2020 . FQHC GAFs are updated periodically and located on the Centers for Medicare & Medicaid Services (CMS) FQHC Center. $226.07 (GAF = .971) Medicare Revenue Statistics Based on the 2017 & 2016 UDS Data (Table 9D ... Medicare FQHC PPS base payment rate 2020 base payment rate of $173.50 includes application of the final FQHC-specific market basket of 2.2% (versus the 2019 MEI increase Make sure your billing staffs are aware of these changes. The unadjusted 2020 FFS average payment for these two codes is $13.53. A FQHC may submit a Medicare claim for a billable • Rates here are based on the 2020 Medicare Physician Fee Schedule (PFS); no Geographical Adjustment Factor (GAF) or Geographic Practice Cost Index (GPCI) has been applied. New Patient Adjustment. FQHCs can expect the payment to be slightly higher or lower depending Medicare PPS Resources General Resources: 330 Health Center authorizing legislation; Medicare GPCI, which is the basis for the Medicare FQHC PPS Geographic Adjustment Factor (GAF) A FQHC may submit a Medicare claim for a billable If an actual or apparent conflict between this document and an agency rule arises, the agency rules apply. Every effort has been made to ensure this guide’s accuracy. Notes: Rates here are based on the 2020 Medicare Physician Fee Schedule (PFS); no Geographical Adjustment Factor (GAF) or Geographic Practice Cost Index (GPCI) has been applied. FQHCs can expect the payment to be slightly higher or lower depending on the GAF/GPCI. About HRSA. Note: Rates here are based on the 2020 Medicare Physician Fee Schedule (PFS); not Geographical Adjustment Factor (GAF) or Geographic Practice Cost Index (GPCI) has been applied. 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