FQHC/RHC behavioral health encounter rate: Medicaid rates by state

This is a service-level benchmark rather than a single code: each state's headline rate for FQHC/RHC behavioral health encounter rate is chosen to match the same service and the same provider level.

• Provider level. States are compared at the same provider level wherever the schedule distinguishes one. Rates for other levels on file (any qualified provider) are kept separate, never mixed into this ranking.
• Unit. None of the 1 schedules prints a separate unit for their headline rate, so each amount is a flat payment for one service as the code defines it. The ranking uses the rate as published, so read the unit before comparing two states.
• Variants. 1 of the 1 states publish more than one rate for this service (by modifier, program, setting or provider type); the headline rate is the one that matches the comparison, and the workspace lists every variant.
• Depth. 1,603 rates for this service are on file across all states, versions and provider levels; this page shows one headline rate per state.

The highest-paying state, Illinois, pays $82.03; the lowest, Illinois, pays $82.03. 1 of the 1 states pay above the median of —. Common reasons rates for clinics (FQHC/RHC) services spread this way:

• Health center prospective payment rates are specific to each clinic, based on its own costs, so a state-level figure is a reference point rather than what every clinic is paid.
• States may pay health centers under an alternative payment method that the clinic agrees to.

Billing notes

A health center is paid one encounter rate per qualifying visit, whatever services the visit includes.