Reimbursement Information for RHC and FQHC Providers

This section will provide guidance to the Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) providers on reimbursement information under the TennCare Medicaid program.

Please see the following documents related to TennCare’s moratorium period, the reporting requirements for the Prospective Payment System settlement requests, and other applicable TennCare guidance:

Reimbursement Manual and CPT Code List:

PPS Settlement Manual for FQHC and RHC Providers (revised April 2024)

Procedure Codes Eligible for PPS Settlement (revised April 2024)

Memos:

Memo on RHC Moratorium and FQHC/RHC Final Rate Setting

FAQ on RHC Moratorium and FQHC/RHC Final Rate Setting

PCP Directed Payment Materials

FQHCRHCs Reporting F Codes on Settlement Reports

FQHC RHC Hospital Visits Memo

FQHC RHC Vaccine Memo

COVID-19 Vaccine Counseling Memo

Adding and Reporting Behavioral Health Visits Memo