Does Medicare Cover Federally Qualified Health Center (FQHC) Services?

Medicare covers federally qualified health center (FQHC) services that are considered medically necessary at specific locations. Medicare Part B covers 80 percent of the cost of any services, leaving you to pay 20 percent. There is no deductible. Also, all preventive services are free.

Medicare Coverage for Federally Qualified Health Center Services

Federally qualified health centers (FQHCs) and the services provided are covered under Medicare – specifically Medicare Part B.

An FQHC can offer a variety of outpatient and primary care and, like most treatments and services available through Original Medicare, is covered if deemed a medical necessity.

Covered visits must be face-to-face and take place with an FQHC practitioner.

Where Can an FQHC Visit Take Place?
  • Home
  • Assisted living facility
  • Skilled nursing facility
  • Scene of an accident

Medicare will not cover your FQHC visits if they occur at an inpatient or outpatient hospital department or a facility that excludes those types of services.

Medicaid beneficiaries should also be eligible to receive treatment and services at FQHCs.

Medicaid is an assistance program designed to help you receive healthcare coverage if you meet certain requirements, like having a low income.

Did You Know?
About 41 percent of FQHC patients had Medicaid through CHIP.

Federally qualified health centers are also covered through Medicare Part C.

Medicare Advantage plans include everything under Original Medicare, so an FQHC visit would also be covered.

Expected Costs for Federally Qualified Health Center Services

Medicare Part B pays for 80 percent of the cost of any services you receive at a center – which means you are responsible for the remaining 20 percent.

You do not have to pay a deductible or coinsurance.

Preventive services are also available through an FQHC at no cost to you. Additionally, there are discounts available if your income is limited.

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Where Can You Find an FQHC?

Federally qualified health centers are in rural and urban areas. These centers are meant to help underserved communities and populations as a low-cost way to receive healthcare.

According to 2018 United States National Library of Medicine study, the number of FQHCs has increased by more than 80 percent through the previous decade.

Your FQHC care options range from physician services, transitional care and chronic care management.

If you have diabetes or renal disease, you may also be eligible for outpatient diabetes self-management training and medical nutrition therapy through an FQHC. Check with your healthcare provider or local health center to determine what other services might be available to you.

Common Types of FQHCs
  • Community health centers
  • Healthcare-for-the-homeless centers
  • Migrant health centers
  • Public housing primary care centers

The U.S. Health Resources and Services Administration offers a map to easily locate FQHCs near where you live.

Last Modified: September 15, 2021

9 Cited Research Articles

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  3. U.S. Centers for Medicare & Medicaid Services. (2020, April 9). Federally Qualified Health Centers (FQHC) Center. Retrieved from https://www.cms.gov/Center/Provider-Type/Federally-Qualified-Health-Centers-FQHC-Center
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