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. G2012 ($14.80). 1 . Looking for Federally Qualified Health Center (FQHC) services coverage? The unadjusted 2020 FFS average payment for these two codes is $13.53. $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 Since the FQHC GAF is based on where the services are furnished, the payment rate may differ among FQHC sites within the same organization. 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. All Medicare Carrier Locality codes; Carrier Locality State Fee Schedule Area GPCI PW GPCI PE GPCI MP Anesthesia CF FQHC GAF; 10112: 00: AL - Alabama: STATEWIDE: 1.000 See how Medicare can help pay costs for preventive services at approved FQHCs. Federally Qualified Health Centers . 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. FQHCs and LALs by State Federally Qualified Health Centers and Look-Alikes. If an actual or apparent conflict between this document and an agency rule arises, the agency rules apply. 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. About HRSA. • 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 A FQHC may submit a Medicare claim for a billable 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. FQHC GAFs are updated periodically and located on the Centers for Medicare & Medicaid Services (CMS) FQHC Center. A FQHC may submit a Medicare claim for a billable New Patient Adjustment. Effective Date: January 1, 2020 Implementation Date: January 6, 2020. Make sure your billing staffs are aware of these changes. 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. 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. • $173.50 and $232.77 are the FQHC unadjusted CMS PPS rate ceilings • 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. Washington Apple Health (Medicaid) Federally-Qualified Health Centers (FQHC) Billing Guide . January 1, 2020 . 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