FQHC Providers - Refresher on Core and Ambulatory Services

November 22, 2011

Under MaineCare rules, FQHC “Core services” are provided by physicians, physician assistants, advanced practice registered nurses, clinical psychologists, licensed clinical social workers, and licensed clinical professional counselors. Services from an independent licensed or otherwise qualified provider are not covered as a “core service”. This would include physical therapists, laboratories, or hospital outpatient departments. (See Section 31.04-1.)

FQHCs can provide “ambulatory services”, such as physical therapy or laboratory services. (See Section 31-04-2.) These must be included in the scope of project. In addition, the provider must be approved and must follow the MaineCare rules that apply. For example, Section 85 of the MaineCare Benefit Manual applies to physical therapy services.

For enrollment or benefits questions, contact Provider Services at 1-866-690-5585.