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Last Modified: 3/14/2024 Location: FL, PR, USVI Business: Part A

COVID-19: RHC and FQHC lump sum payments information

Rural health clinics (RHCs) and federally qualified health centers (FQHCs) may request lump sum payments for administering COVID-19 vaccines in advance of cost report settlement. CMS will pay you for COVID-19 vaccines and administration at 100% reasonable cost like influenza and pneumonia vaccines.
To request an interim payment prior to the annual cost report submission/settlement, submit one of the following:
1. Interim Form 2552-10, W/S M-4 (RHC Subunit), Form 222-17, W/S B-1 (RHC Freestanding), or Form 224-14, W/S B-1 (FQHC) for the current FYE to date (preferred); or
2. Estimated total cost of administrating COVID-19 vaccines and the program number of COVID-19 vaccines administered based on 60-90 days of actual COVID-19 data.
Lump sum payments will be processed within 30 days of receipt of the request.
For this request, please use this attached form here compressed file
Mail or email (preferred) your information to:
PARD Reimbursement
First Coast Service Options, Inc.
2020 Technology Parkway, Suite 100
Mechanicsburg, PA 17050
email: InterimReimbReviews@fcso.com
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.