New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 310 - HEALTH CARE PROFESSIONAL SERVICES
Part 4 - FEDERALLY QUALIFIED HEALTH CENTER SERVICES
Section 8.310.4.14 - NON-COVERED SERVICES AND SERVICE LIMITATION
Current through Register Vol. 35, No. 18, September 24, 2024
FQHC services are covered when provided in outpatient settings only, including a client's place of residence, which may be a skilled nursing facility or a nursing facility or other institution used as a client's home. FQHC services are not covered in a hospital as defined in section 1861(e)(1) of the Act.
A. Service limitations: An FQHC may be compensated for provision of other "ambulatory services" covered in the medicaid fee-for-service program (per the Balanced Budget Act of 1997). However, an FQHC must meet licensing and certification requirements for those services as specified in the applicable MAD policy manual section for the specific service.
B. Location of clinic:
C. Other restrictions: FQHC service providers are subject to the limitations and coverage restrictions which exist for other medicaid services. See 8.301.3 NMAC, General Non-covered Services.