How California health centers actually get paid.
Plain-English guides to the reimbursement rules that decide your revenue, written by a team that bills them every day and with primary-source links so you can check the regulatory details.
What are these guides?
These are practical explanations of how FQHC and community health center reimbursement works in California, covering the Prospective Payment System, wrap-around reconciliation, the Alternative Payment Methodology, sliding-fee billing, and how to evaluate a billing company. They are written for health center leaders, not for billers, and they cite CMS, DHCS, and HRSA so you can check the source yourself.
Start here.
Each guide carries a visible last-updated date and cites the primary sources it is built on.
California's FQHC APM, Explained
The per-member-per-month model rolling out in cohorts since 2024: what changes, and what doesn't.
Read the guide → Decision guideHow to Switch FQHC Billing Companies
The staged, parallel-run transition that keeps cash flow intact, plus what to settle before you sign.
Read the guide → ReimbursementThe FQHC PPS Rate, Explained
How the per-visit prospective payment rate is set, what adjusts it, and why it is the number everything else measures against.
Read the guide → Decision guideHow to Choose an FQHC Billing Company
The questions to ask, the answers that matter, and how to tell a specialist from a generalist.
Read the guide → ComplianceSliding-Fee Billing, Explained
How the sliding fee discount program affects billing, and why discounted care still has to be billed correctly.
Read the guide → ComparisonFQHC vs RHC Billing
Two safety-net clinic types, two payment worlds, and where California treats them the same.
Read the guide → ComparisonBest FQHC Billing Companies in California
An honest, disclosed comparison: who each company fits, and when a national firm beats a specialist.
Read the guide → ReportingUDS Reporting, Explained
What health centers must report to HRSA every year, and why your billing data decides the report months before you file.
Read the guide → RevenueCharge Capture, Explained
Where hospital medicine loses charges at handoffs, discharges, and critical care, and the reconciliation that stops it.
Read the guide →Or see how we do this work.
About these resources.
Who writes these guides?
They are written by our billing team from day-to-day work billing Southern California health centers, and they cite primary sources such as CMS, DHCS, and HRSA so you can verify anything yourself.
Is this legal or compliance advice?
No. These guides are general information to help health center leaders understand how their reimbursement works. Rules change and depend on your specific circumstances, so verify against primary sources and your own advisors before acting.
How often are they updated?
Each guide carries a visible last-updated date. We revise them when the underlying rules change, such as when CMS updates the annual PPS rate or DHCS changes program requirements.
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Last reviewed: August 2026