The unadjusted 2020 FFS average payment for these two codes is $13.53. FQHCs can expect the payment to be slightly higher or lower depending on the GAF/GPCI. $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 • 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 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) FQHCs can expect the payment to be slightly higher or lower depending on the GAF/GPCI. Federally Qualified Health Centers . 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 A FQHC may submit a Medicare claim for a billable FQHCs can expect the payment to be slightly higher or lower depending on the GAF/GPCI. A FQHC may submit a Medicare claim for a billable 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. • 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. Since the FQHC GAF is based on where the services are furnished, the payment rate may differ among FQHC sites within the same organization. About HRSA. Looking for Federally Qualified Health Center (FQHC) services coverage? New Patient Adjustment. Make sure your billing staffs are aware of these changes. FQHCs and LALs by State Federally Qualified Health Centers and Look-Alikes. 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. Washington Apple Health (Medicaid) Federally-Qualified Health Centers (FQHC) Billing Guide . Every effort has been made to ensure this guide’s accuracy. HRSA programs provide health care to people who are geographically isolated, economically or medically vulnerable. Effective Date: January 1, 2020 Implementation Date: January 6, 2020. If an actual or apparent conflict between this document and an agency rule arises, the agency rules apply. 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. • $173.50 and $232.77 are the FQHC unadjusted CMS PPS rate ceilings 1 . Select a State or Territory and click the “Submit” button. G2012 ($14.80). 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. FQHC GAFs are updated periodically and located on the Centers for Medicare & Medicaid Services (CMS) FQHC Center. FQHCs can expect the payment to be slightly higher or lower depending January 1, 2020 . See how Medicare can help pay costs for preventive services at approved FQHCs. Pay costs for preventive services at approved fqhcs every effort has been made to ensure this Guide ’ accuracy. 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