Jeffrey Wade
Federally Qualified Health Centers (FQHCs) are safety-net providers that offer comprehensive, high-quality, and culturally competent healthcare services to underserved communities. They are funded by the Health Resources and Services Administration and provide care to anyone, regardless of their insurance status or ability to pay. FQHCs set their own charges for services, but they must offer a uniform set of charges for all patients treated within the clinic. If patients do not have insurance, FQHCs inform them about their sliding fee program, which determines charges based on family size and income level.
| Characteristics | Values |
|---|---|
| Definition | Federally Qualified Health Center (FQHC) |
| Type of Organization | Community Health Center |
| Funding | Special funding from the federal government |
| Patient Criteria | Anyone who needs healthcare, regardless of insurance status or ability to pay |
| Services | Comprehensive, high-quality, culturally competent, and accessible healthcare |
| Service Charges | Set by each FQHC; uniform within the clinic but with a sliding fee scale for uninsured or underinsured patients |
| Governance | Patient board |
| Location | Often in underserved communities |
| Medicare Reimbursement | Enhanced reimbursement from Medicare and Medicaid |
| Rural vs. Urban | Rural FQHCs have higher margins and receive a higher percentage of patient revenue from uninsured patients |
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What You'll Learn
- Federally Qualified Health Centers (FQHCs) provide care to anyone, regardless of their insurance status or ability to pay
- FQHCs are funded by the Health Resources and Services Administration
- FQHCs set their own charges for services, but must have a set list of charges that are uniform for all patients
- Medicare Part B covers a broad range of primary and preventive services offered by FQHCs
- FQHCs offer dental, behavioural health, and telemedicine services
Federally Qualified Health Centers (FQHCs) provide care to anyone, regardless of their insurance status or ability to pay
Federally Qualified Health Centers (FQHCs) are public health centers that provide healthcare services to underserved communities. They are funded by the Health Resources and Services Administration and governed by a patient board. They are also known as "health centers" and provide care to anyone, regardless of their insurance status or ability to pay. This includes people who are uninsured, on Medicare or Medicaid, or have private insurance.
FQHCs offer a wide range of services, including primary and preventive healthcare, laboratory services, dental, behavioral health services, and case management. They are committed to removing barriers to care and providing culturally sensitive and non-discriminatory care. They set their own charges for services but must have a set list of uniform charges for all patients within that clinic. For patients without insurance or who are underinsured, FQHCs offer a "sliding fee" program based on family size and income level, ensuring that no patient is turned away due to an inability to pay.
FQHCs are selected by the federal government to receive special funding because they provide comprehensive, quality care to anyone who needs it. They often utilize telemedicine technologies to deliver clinical services, especially for mental health and substance use disorder services. As of 2023, 98.46% of health centers utilized telemedicine technologies, with 93.82% using it for mental health services and 60.21% for substance use disorder services.
FQHCs also receive funding through the Health Center Program, which provides opportunities for new and continued funding for healthcare delivery sites to expand access to affordable, accessible, quality, and cost-effective primary healthcare services for underserved communities. This funding helps FQHCs serve millions of people, providing critical care and reducing barriers to healthcare access.
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FQHCs are funded by the Health Resources and Services Administration
Federally Qualified Health Centers (FQHCs) are outpatient clinics that qualify for specific reimbursement systems under Medicare and Medicaid. They are funded by the Health Resources and Services Administration (HRSA), an agency within the US Department of Health and Human Services (HHS).
FQHCs are community health centers selected by the federal government to receive special funding because they provide comprehensive, quality care to anyone who needs it, regardless of their ability to pay. This means that FQHCs treat patients with insurance and those without. Patients who are uninsured or underinsured—those with high deductibles and co-pays—can be charged for their care using an income-based sliding fee scale. No patient is turned away for their inability to pay.
FQHCs qualify for funding under Section 330 of the Public Health Service (PHS) Act, which defines the Health Center Program as a funding opportunity for organizations serving underserved communities. The HRSA's Bureau of Primary Health Care offers funding opportunities for new and continued Health Center Program funding. For example, New Access Point (NAP) funding provides operational support for new healthcare delivery sites to expand access to affordable, accessible, and quality primary healthcare services for underserved communities.
FQHCs also qualify for enhanced reimbursement from Medicare and Medicaid. Certain tribal organizations and "FQHC Look-Alikes" (organizations that meet PHS Section 330 eligibility requirements but do not receive grant funding) may also receive special Medicare and Medicaid reimbursement. The HRSA has also offered grants to support expansion, renovation, equipment purchases, or new construction when authorized and funded by Congress.
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FQHCs set their own charges for services, but must have a set list of charges that are uniform for all patients
Federally Qualified Health Centers (FQHCs) are community health centers that receive special funding from the federal government. They provide comprehensive, quality healthcare to anyone who needs it, regardless of their ability to pay. FQHCs are known for their commitment to removing barriers to care for all patients. This includes providing appointments when patients need them and offering after-hours care.
FQHCs set their own charges for services, but they must follow certain guidelines. For patients who are uninsured, FQHCs can charge for care using an income-based sliding fee scale. This scale can also be applied to charges for underinsured patients, who have high deductibles and co-pays. Importantly, no patient is ever turned away from an FQHC due to an inability to pay.
FQHCs must also have a set list of charges that are uniform for all patients. This means that the fees for specific services are consistent across all patients, regardless of their financial situation. This uniform fee structure ensures fairness and transparency in the billing process.
FQHCs have the flexibility to offer "one-stop shopping," providing a range of services such as primary and preventive healthcare visits, laboratory services, dental, behavioral health services, and case management. This comprehensive approach to healthcare improves accessibility and convenience for patients.
In terms of reimbursement, FQHCs are eligible for enhanced reimbursement from Medicare and Medicaid. They can also receive reimbursement for telehealth services provided during the COVID-19 public health emergency and for mental health visits using interactive, real-time audiovisual and audio-only technology.
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Medicare Part B covers a broad range of primary and preventive services offered by FQHCs
Federally Qualified Health Centers (FQHCs) are community health centers that receive special funding from the federal government to provide comprehensive, quality care to anyone who needs it, regardless of their ability to pay. FQHCs are committed to removing barriers to care for all patients, providing appointments when they need them, and after-hours care. They serve a critical role in providing healthcare to underserved communities and individuals who might not otherwise have adequate access to healthcare.
FQHCs are reimbursed by Medicare for the services they provide to patients. This reimbursement is enhanced for Medicare and Medicaid, and certain tribal organizations and FQHC Look-Alikes may also receive special reimbursement. FQHCs can also receive funding through the Health Center Program, which provides support for new and existing healthcare delivery sites to expand access to affordable, accessible, and quality primary healthcare services for underserved communities.
FQHCs play a vital role in ensuring that individuals with limited financial resources can access the healthcare they need. They provide culturally sensitive and non-discriminatory care, serving nearly 29 million people each year. FQHCs also assist patients in obtaining affordable health insurance coverage, helping nearly 1,500 people annually with insurance through programs like Medicare and Medicaid.
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FQHCs offer dental, behavioural health, and telemedicine services
Federally Qualified Health Centers (FQHCs) are community health centers that receive special funding from the federal government. This is because they provide comprehensive, quality care to anyone who needs it, regardless of their ability to pay. FQHCs offer dental, behavioural health, and telemedicine services, treating patients with insurance and those without.
FQHCs offer dental services through contractual agreements with local dental service providers. Health centers are eligible to contract with private dentists for dental services provided within their dental facilities. The National Network for Oral Health Access provides resources to help health centers plan and implement contracts for dental services. Additionally, mobile units and school-based programs have been used to expand dental services to offsite locations.
FQHCs also provide behavioural health services, including mental health and substance use disorder services. Telebehavioural health, or telemental health, has been implemented in some FQHCs to expand their behavioural health services. According to 2023 data, 98.46% of health centers utilized telemedicine technologies to deliver clinical services, with 93.82% using telemedicine for mental health services and 60.21% for substance use disorder services.
FQHCs are eligible for Medicare reimbursement for telemedicine services. The CY 2025 Medicare Physician Fee Schedule Final Rule allows audio-only services for any telehealth visit if the practitioner's site can offer both audio and video communications but the patient cannot or declines to use video technology. FQHCs also qualify for enhanced reimbursement from Medicaid.
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Frequently asked questions
FQHC stands for Federally Qualified Health Center. These are community health centers that receive special funding from the federal government because they provide comprehensive, quality care to anyone who needs it, regardless of their ability to pay.
Anyone can go to an FQHC, regardless of their insurance status or ability to pay. FQHCs provide care to uninsured individuals, Medicare and/or Medicaid beneficiaries, people with private insurance, and many others.
To be treated at an FQHC, a new patient can visit their nearest FQHC and fill out a new patient intake form. Some FQHCs have websites that allow new patients to book an appointment and download intake forms in advance.
FQHCs set their own charges for the services they provide and choose which services to include within their clinic. When patients do not have health insurance coverage, FQHCs inform them about their "sliding fee" program, which determines charges based on family size and income level.
