Attention FQHCs: Who Is Your MAC?
National Government Services serves as the CMS Jurisdiction 6 and K MAC for FQHCs in 44 states, Washington D.C. and the five United States Territories of American Samoa, Guam, Northern Mariana Islands, Puerto Rico and U.S. Virgin Islands.
Most FQHCs in the 44 states, Washington D.C. and territories will bill FQHC claims to NGS. However, newly enrolled FQHCs will be under the A/B MAC assigned to their state. For example, NGS would serve a new FQHC in the primary states of Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Hampshire, New York, Rhode Island, Vermont and Wisconsin but a FQHC with a new NPI and PTAN in Florida would be assigned to Jurisdiction N.
Furthermore, OJP may have NGS as their A/B MAC for FQHC claims but another MAC that processes Part B claims (CMS 1500 form). To keep track of who your FQHC MAC is, we encourage you to check the following resources.
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Friendly Reminder
NGS receives questions about billing for services not included in the FQHC benefit. Please review the following resource for additional information:
Posted 12/20/2024