Nevada Medicaid and Federally Qualified Health Centers


FQHCs are under an encounter reimbursement methodology for approved services provided by a Qualified Health Professionals. Services not approved as an FQHC encounter but are an approved Nevada Medicaid 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), 2900-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, culturally competent, quality primary health care services to medically underserved communities and vulnerable populations. Additional health services are provided as appropriate and necessary per Nevada State Plan. Services provided at an FQHC may include:

  • Primary care services
  • Early periodic screenings
  • Preventive health services
  • Some Diagnostic laboratory and radiology services
  • Family planning services
  • Gynecological exams and prenatal services
  • Vision and hearing screening
  • Dental services
  • Mental/behavioral health services

Qualified Health Providers at an FQHC may include:

  • Physicians, Advanced Practice Registered Nurses, Physician Assistants, Podiatrists, Certified Registered Nurse Midwives, Dentists, Psychologists, Optometrists, Opticians, Registered Dieticians

FQHCs are under an encounter reimbursement methodology for approved services provided by a Qualified Health Professionals. Services not approved as an FQHC encounter but are an approved Nevada Medicaid 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), 2900-FQHC.

Enrollment, billing information, and prior authorization information can be found at https://www.medicaid.nv.gov/

    Contact

    Erin Lynch, MPH
    Chief, Medical Programs Unit
    erin.lynch@dhcfp.nv.gov
    (775) 684-3654

    Charles Damon
    SSPS II, Medical Programs Unit
    cdamon@dhcfp.nv.gov
    (775) 684-7598

      Links

      Resources

      Centers for Medicare and Medicaid Services – FQHC Website: CMS - FQHC Center

      Health Resources and Services Administration Website: HRSA

      Nevada Primary Care Association Website: www.nvpca.org/

        Meetings & Workshops