Federally Qualified Health Centers (FQHC)


Welcome to the State of Nevada Division of Health Care Financing and Policy (DHCFP) Federally Qualified Health Centers (FQHC) webpage. FQHCs are defined by the Health Resources and Services Administration (HRSA) as health centers providing comprehensive primary and preventive healthcare to medically underserved and vulnerable populations. Additional health services are provided as appropriate and necessary. Nevada currently has six FQHCs that provide services at 33 sites across the state.

Services provided at an FQHC include:

  • Physician services; 
  • Services and supplies incident to the services of physicians;
  • Nurse practitioner (NP), physician assistant (PA), certified nurse-midwife (CNM) , clinical psychologist (CP), and clinical social worker (CSW) services;
  • Services and supplies incident to the services of NPs, PAs, CNMs, CPs, and CSWs;
  • Visiting nurse services to the homebound in an area where the Centers for Medicare and Medicaid Services (CMS) has determined that there is a shortage of Home Health Agencies;
  • Otherwise covered drugs that are furnished by, and incident to, services of a FQHC provider; and
  • Outpatient diabetes self-management training and medical nutrition therapy for patients with diabetes or renal disease.

FQHCs are under an encounter reimbursement methodology for HRSA approved services. Services not recognized by HRSA as an FQHC encounter which are an approved Nevada State Plan service are considered ancillary and will be reimbursed accordingly under their provider type. Nevada Medicaid FQHC policies are located within the Medicaid Service Manual (MSM), Chapter 600, Physician Services.

Enrollment for new FQHC centers is provided through Nevada Medicaid's QIO-like vendor, Hewlett Packard Enterprise Services, HPES. HPES processes all Medicaid fee-for-service claims and prior authorization requests.

     

    Last Edited: 10/4/2016