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FQHC Reimbursement Calculator

Project monthly reimbursement based on encounter volume, payer mix, and your state PPS rate.

Inputs

Payer mix (must total 100%)

Total: 100%

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Use this calculator to model your FQHC’s monthly reimbursement based on the prospective payment system (PPS) rate, encounter volume, and your payer mix.

Why it matters

Most new FQHCs underestimate the reimbursement gap between commercial rates and PPS-based payments. This tool surfaces that gap upfront so you can plan accurately.

Want a state-specific PPS rate analysis?

Our team builds custom reimbursement models for prospective FQHCs.

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