The FQHC Payer Policy Matrix

Name: FQHC Payer Policy Matrix
Author: ASP-RCM Solutions

A live, sourced view of state Medicaid policy for federally qualified health centers and rural health clinics across all 50 states and DC: PPS and APM rates, MCO wraparound and reconciliation, encounter billing rules, telehealth, dental and behavioral health. Every cell links to the primary source. Updated by the ASP-RCM industry-intelligence team.

51 jurisdictions 8 payer columns ... recent updates indexed Coverage window: Jul 2025 → Sep 2026

Federal Layer · Applies to every state below

Recent federal-level moves rippling across every state Medicaid program and commercial payer simultaneously. Click any card for the primary source.

State / Jurisdiction	PPS / APMrates, MEI, scope	WraparoundMCO reconciliation	Encounter billingT1015, same-day	Telehealthdistant site	Dentalencounter policy	Behavioral healthintegration, CCBHC	Managed careMCO contracting	Otherstate-specific

CELL TYPES: Rate cut Policy change Auth / Cap change Expansion / Win Administrative No verified change

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