​​​​​​​​Federally Qualified Health Centers and Rural Health Clinics​

Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) are safety net providers that deliver prevention and primary service in an outpatient clinic setting. This webpage is designed to provide additional information, resources, and helpful links pertaining to Federally Qualified Health Center and Rural Health Clinic programs available to Medi-Cal providers and members. 

Medi-Cal Members

Find A Health Center

The Health Resources and Service Administration (HRSA) has a health center locator tool to find a Federally Qualified Health Center (FQHC). You can search by address, state, county, or zip code. FQHCs are located in most cities and many rural areas.  ​

Providers

Clinic Licensure

The California Department of Public Health (CDPH) Licensing & Certification (L&C) Program is responsible for licensing primary care clinics. The L&C program uses state and federal laws and regulations to evaluate health facilities.

Link to license & certification application unit​

How To Become A FQHC

To become a FQHC, also known as a Health Center, an organization must meet certain criteria: 

• Be located in or serve a high need community.
  
• Be governed by a community board that is at least 51% made up of health center patients.
  
• Provide comprehensive healthcare services on a sliding fee scale based on ability to pay.
  
• Become a Health Center Program award recipient or Health Center Program look-alike.
  

FQHCs are primary care clinics that receive federal funds to provide healthcare services to underserved communities. They operate in both rural and urban areas designated as shortage areas. 

Organizations that are eligible to apply for FQHC status include public or nonprofit organizations that provide comprehensive primary health care to underserved populations. You may also refer to ​PIN 2008-01, Defining Scope of Project and Policy for Requesting Changes.​

How To Become A RHC

A clinic may be certified as a RHC in California. An RHC is "a clinic that is located in a rural area designated as a shortage area, is not a rehabilitation agency or a facility primarily for the care and treatment of mental diseases, and meets all other requirements of this subpart," pursuant to Title 42 Code of Federal Regulations (CFR) section 491.2. To apply for Initial certification, you must complete the required application packet and submit it to the California Department of Public Health. Refer to CFR Part 491 Subpart A – Rural Health Clinics for information regarding conditions of certification. ​​

​​​​How to Enroll as a Medi-Cal MCP Provider

​Beyond an initial PPS visit, clinics must be contracted with MCPs to provide ongoing care and services to members enrolled with an MCP. Furthermore, clinics and MCPs must ensure the member is properly assigned to their clinics of choice.

Provider Resources

• ​​​​California Medicaid State Plan & State Plan Amendments (SPAs)​​

DHCS Division Office​s

• Audits & Investigations
• Indian Health Program/Office of Tribal Affairs
• For additional information related to Tribal FQHCs: Updates on Tribal Federally Qualified Health Center Medi-Cal Provider Type
• For additional information related to Indian Health Programs: Indian Health Program
  
• ​Managed Care Plan Division

DHCS Provider Manuals and Notices

• ​Medi-Cal Providers Portal Home Page
• Medi-Cal Provider Manuals
  
• ​Bulletins, Information Notices, and Letters
  

DHCS Forms & Documents:

• ​​Audits & Investigations- Financial Review Division Cost Report Forms & Documents

DHCS Legislative Authority

• California Statutes, Regulations, & Laws​
• Health and Safety Code 1200 - 1210​
• Welfare & Institutions Code 14132.100
  

DHCS Data & Statistics Reports​

• ​​​FQHC and RHC Current R​​a​t​​e​s​​​​​​​
  

Department of Health Care Access & Information (HCAI)​​

• ​California State Office of Rural Health
• Clinic Utilization - HCAI
  

Centers for Medicare & Medicaid Services (CMS)

• Rural Health Clinics
• Federally Qualified Health Centers​​​​​

​​DHCS Contacts: 

• ​Fiscal Intermediary Phone Number: (800) 541-5555​ for billing and claim submission questions. 
• ​CA-MMIS Fiscal Intermediary - Claims Submission and Billing Questions: Telephone Service Center (TSC). For faster access to TSC resources, refer to the TSC Main Menu Prompt Options Guide. 
• For “Questions about benefits and PPS rates"
• For rate setting cost report submissions only​.
• For CSOSR submissions only​.
• To access the ECRS system for submission of the annual Reconciliation Requests.
• For Reconciliation Request submission and ECRS system set-up questions.
• Currently used by providers for all questions.
• For enrollment of intermittent clinics.​
• For all programs at DHCS.

DHCS Stakeholder List

If you are not a subscriber and would like to receive DHCS updates, please sign up on the DHCS website. To view previous stakeholder announcements, visit the DHCS Stakeholder News webpage. ​

Reporting Medi-Cal Fraud

Health Care Fraud is a Crime.

• 24 hour hotline (800) 822-6222
  
• On-line web complaint form
• Visit: DHCS Fraud