FQHC (Federally Qualified Health Center)
Federally Qualified Health Center
A community-based safety-net provider that meets requirements at section 1861(aa) of the Social Security Act and receives prospective payment from Medicare and enhanced reimbursement from Medicaid.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Telehealth
- Acronym for
- Federally Qualified Health Center
- Primary sources
- 1
- Workspace handoff
- ask d3 →
Where this comes up
Telehealth coding, place-of-service, modifier (95, GT, GQ, FQ, FR), and post-PHE policy parity all converge here. State licensure rules and DEA controlled-substance prescribing rules add a second compliance layer most billers learn about only after the first denial.
Full definition
What it is in practice
HRSA administers FQHC funding and oversight. CMS pays FQHCs under the Prospective Payment System. UDS reporting is annual.
How it shows up in your practice
FQHC billing uses G-codes specific to the FQHC PPS. Telehealth and behavioral-health integration are common revenue lines.
Sources
- HRSA — UDS Reportinghttps://bphc.hrsa.gov/data-reporting/uds-reporting
Look up FQHC billing rules in Ask D3
Open ask d3 →Related terms
- TelehealthRural Health ClinicA federally certified clinic in an underserved rural area that bills Medicare under a special all-inclusive rate methodology.
- EnrollmentUDS ReportingThe Uniform Data System annual report required of HRSA-funded health centers.
- Compliance ProgramValue-Based CareReimbursement models that pay providers based on quality and outcomes rather than fee-for-service volume.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryUDS ReportingThe Uniform Data System annual report required of HRSA-funded health centers.
- GlossaryRural Health ClinicA federally certified clinic in an underserved rural area that bills Medicare under a special all-inclusive rate methodology.
- GlossaryValue-Based CareReimbursement models that pay providers based on quality and outcomes rather than fee-for-service volume.
- GlossarySliding Fee Discount ScaleA discount schedule based on family income and size, required of HRSA-funded health centers for patients at or below 200% of FPL.
- GlossaryAudio-Only TelehealthTelehealth services delivered via telephone or other audio-only technology, without a video component.
- GlossaryDistant SiteUnder Medicare telehealth rules, the location of the practitioner delivering the telehealth service.
- GlossaryInterstate Medical Licensure Compact (IMLC)A compact allowing physicians licensed in one member state to obtain expedited licensure in other member states.
- GlossaryModifier 93 (Audio-Only Synchronous Telehealth)CPT modifier indicating a synchronous telemedicine service rendered via audio-only technology.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.