Historically Excepted Tribal FQHCs (formerly known as Grandfathered Tribal FQHCs)

A tribe or tribal organization clinic can get certified and paid as a historically excepted tribal FQHC, if it’s:

• Operating under the Indian Self-Determination Act
• Billing as a provider-based to an Indian Health Services (IHS) hospital
• No longer operating as a provider-based department of an IHS hospital
• Meeting conditions in 42 CFR 413.65(m) on or before April 7, 2000
• Changed status from IHS to a tribal operation, or vice versa, on or after April 7, 2000
• Realigned the clinic from IHS or tribal hospital to another IHS or tribal hospital, such that the organization no longer meets the Conditions of Participation (CoPs)
• Meeting all FQHC certification and payment requirements

Payment Policy/Billing

• CY 2025 Payment Rate Update (PDF)
• CY 2024 Payment Rate Update
• CY 2023 Payment Rate Update
• CY 2022 Payment Rate Update

Training & Presentation Materials

• Grandfathered Tribal FQHC Training (PDF)
• All Tribes Call on Grandfathered Tribal FQHCs Presentation (PDF)
• Specific Payment Codes for Grandfathered Tribal FQHCs (PDF)