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2012 Texas Medicaid Provider Procedures Manual

Clinics and Other Outpatient Facility Services Handbook : 4. Federally Qualified Health Center (FQHC) : 4.4 Claims Filing and Reimbursement : 4.4.2 Reimbursement

FQHCs are reimbursed provider-specific prospective payment system encounter rates in accordance with 1 TAC §355.8261.
FQHCs are exempt from the mandated rate reductions except for family planning services.
Texas Medicaid implemented mandated rate reductions for certain services. Additional information about rate changes is available on the TMHP website at
Refer to:
Subsection 2.2, “Fee-for-Service Reimbursement Methodology” and subsection 2.3, “Reimbursement Reductions” in Section 2, “Texas Medicaid Fee-for-Service Reimbursement” (Vol. 1, General Information) for more information about reimbursement.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2011 American Medical Association. All rights reserved.