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Clinic Providers
Information for Federally Qualified Health Centers, Rural Health Centers, and Outpatient Health Facilities
Clinic Providers

Each clinic type has various requirements for enrollment. The Provider Enrollment Unit can assist you with the enrollment process.

Reimbursement Methodologies

Ambulatory Health Care Clinics are paid on a fee-for-service basis as set forth in Chapter 5160-13 of the Ohio Administrative Code.

Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) are paid on a prospective payment system as set forth in Chapter 5160-28 of the Ohio Administrative Code. Per Visit Payment Amounts (PVPAs) are effective October 1 through September 30 and are inflated by the Medicare Economic Index (MEI) in effect on October 1 of each year. Annual cost reports are not required. Cost report needs to be filed only if facility is new or is adding a new service

"Cost report" is a report of FQHC or RHC costs together with all schedules, attachments, and supporting documentation, in accordance with the instructions specified for the form. For purposes of establishing FQHC PVPAs, ODM uses form ODM 03421, "Federally Qualified Health Center Cost Report" (rev. XX/2021).

For purposes of establishing RHC per-visit payment amounts, ODM uses Medicare form CMS-222-17, "Independent Rural Health Clinic Cost Report" (rev. 5/2018).