471 NAC 29-003. Payment for Services Provided by FQHCs: (NMAP) makes payment for services provided by federally-qualified health centers (FQHCs) as defined in section 1905(a)(2)(C) of the Social Security Act NMAP will pay for services provided by FQHCs under a prospective payment system (PPS) that is in compliance with Section 1902(bb) of the Social Security Act

29-003 Payment for Services Provided by FQHCs: (NMAP) makes payment for services provided by federally-qualified health centers (FQHCs) as defined in section 1905(a)(2)(C) of the Social Security Act NMAP will pay for services provided by FQHCs under a prospective payment system (PPS) that is in compliance with Section 1902(bb) of the Social Security Act. The Department assures that payment to an FQHC will result in payment to the center of an amount which is at least equal to the Prospective Payment System rate. 29-003.01 Definitions: The following definitions apply in this chapter. Encounter means a face-to-face visit between a Medicaid-eligible patient and a physician, physician assistant, nurse practitioner, nurse midwife, specialized nurse practitioner, visiting nurse, clinical psychologist, or clinical social worker during which an FQHC service is rendered. Encounters with more than one health professional and multiple encounters with the same health professional which take place on the same day and at a single location constitute a single visit, except for cases in which the patient, subsequent to the first encounter, suffers an illness or injury requiring additional diagnosis or treatment. Encounter Rate means the all-inclusive PPS rate that the Department reimburses the FQHC for an encounter. Encounter Payments means PPS rate paid to the FQHC by the Department multiplied by the number of encounters billed. Medicare Cost Report means the report filed by each provider with its Medicare intermediary as required in the Medicare Rural Health Clinic and Federal Qualified Health Center Manual. Prospective Payment System (PPS) means the payment system where in the reimbursement rate is paid for services provided.