Benefit: Clinic (FQHC and RHC)

Definition: A Federally Qualified Health Center (FQHC) is a clinic that provides primary and preventive outpatient health care.

A Rural Health Clinic (RHC) is a clinic that is located in a rural area that has a health
care provider shortage. RHCs provide primary and preventive health care and related diagnostic services. In addition, RHCs may provide adult health screening services, Child Health Check-Ups, family planning services, optometric, podiatry, chiropractic and mental health services and the Vaccines for Children program.

FQHC and RHC services are performed by advanced registered nurse practitioners, chiropractors, psychologists, social workers, dentists, optometrists, physicians, physician assistants, and podiatrists.

Limits:  Services are limited to one visit, per day, per recipient. Any service that applies to another benefit, such as dental, must apply that specific limit also. For example, mental health services are limited to 26 visits per calendar year.

Exceptions: None

Co-pays: $3 copay for FQHC/RHC services, per clinic, per day, unless exempt.

Reform items that can vary: Copays may vary