224-14 FQHC Transmittals

All Transmittal Information for the 224-14

 

224-14 Approval Letter 
224-14 T-8 from CMS Website 

 

FQHC Transmittal 8

 

The FQHC, 224-14 system was updated to Transmittal 8 by CMS, on September 26, 2025. Transmittal 8 is effective for cost reporting periods that end after December 31, 2024. 

HFS was approved for Transmittal 8 on November 13, 2025. 

The primary changes in Transmittal 8 were to update the Federally Qualified Health Centers (FQHC) Cost Report, Form CMS-224-14, for the revised instructions for Hepatitis B vaccines.

Specific changes include:

Revisions include:

General

·         Updated the expiration date of the information collection instrument.

Worksheet S-2

·         Revised form and instructions for lines 11 and 12 to include the “Paid Claims Verified Current As Of” date.

Worksheet A

·         Added line 49.12 for hepatitis B vaccines and associated medical supplies.

Worksheet B-1

·         Revised instructions for reporting and calculating vaccine costs.

·         Added column 2.03 and instructions for reporting hepatitis B vaccines.

·         Added column 3 and instructions for all vaccines.

Worksheet E-1

·         Shaded lines 6.01 and 6.02, column 1, on the worksheet as the NPR date is already noted on line 8.

·         Revised instructions and footnote on worksheet to reflect column 3 and 5.

Edits

·         Revised edits 1047, 1400S, and 1050B

·         Added edits 1002S, 1055B, 1065B, and 1010E

HFS anticipates updating the FQHC 224-14 system to T-8 the week of November17, 2025.

 

  

 

FQHC Transmittal 7

 

The FQHC, 224-14 system was updated to Transmittal 7 by CMS, on February 29th, 2024. Transmittal 7 is effective for cost reporting periods that end on or after January 1, 2024. 

HFS was approved for Transmittal 7 on March 28, 2024. 



The primary change in Transmittal 7 was the implementation of services for Intensive Outpatient Program in accordance with the CAA 2023, §4124, and to add Marriage and Family Therapist (MFT) and Mental Health Counselor (MHC) to the types of practitioners available to beneficiaries for a mental health visit.

 

Specific changes include:

 

Worksheet S-3, Part I:

·         Added lines 23 through 26 to include the number of intensive outpatient program (IOP) visits in accordance with the CAA 2023, §4124, effective for services rendered on or after January 1, 2024.

Worksheet S-3, Parts II and III:

·         Added lines 9.10 and 9.11 to Part I and lines 23.10 and 23.11 to Part II to include Marriage and Family Therapist (MFT) and Mental Health Counselor (MHC) to the types of practitioners available to beneficiaries for a mental health visit.

Worksheet A:

·         Added new cost centers 31.10 for Marriage and Family Therapists and 31.11 for Mental Health Counselors.

 

Worksheet B, Part I:

·         Added new cost centers 9.10 for Marriage and Family Therapists and 9.11 for Mental Health Counselors. Also added columns 8.01, 10.01, and 12.01 total IOP visits, Medicare IOP visits, and Medicare IOP costs.

Worksheet E:

·         Revised line 1 instructions to include the IOP PPS payments for services rendered on or after January 1, 2024.

Worksheet E-1:

·         Revised line 1 instructions to include the IOP PPS interim payments for services rendered on or after January 1, 2024.

   

HFS will update the FQHC 224-14 system the week of April 1, 2024.

 

 

FQHC Transmittal 6

  

The FQHC, 224-14 system was updated to Transmittal 6 by CMS, on July 28, 2023. Transmittal 6 is effective for cost reporting periods that end on or after July, 31, 2023. 

 

HFS was approved for Transmittal 6 on August 25, 2023. 

 

 

•      The primary change in Transmittal 6 was the revision of Worksheet S, Part I, line 4 to add a fourth Medicare utilization option to reflect vaccines only utilization to accommodate CR 13218, dated June 7, 2023.

•      The Transmittal 6 also revised edit 1050B to accommodate the new utilization option. 

 

    

HFS will update the FQHC 224-14 system the week of August 28, 2023.

 

 

FQHC Transmittal 5

 

The FQHC, 224-14 system was updated to Transmittal 5 by CMS, on October 28, 2022. Transmittal 5 is effective for cost reporting periods that end on or after October 31, 2022. 

 

HFS was approved for Transmittal 5 on November 8, 2022. 

 

§  The primary change in Transmittal 5 was the calculation of Sequestration as follows:

§  No Sequestration for the period 5/1/2020 – 3/31/2022 §  1% Sequestration for the period 4/1/2022 – 6/30/2022 §  2% Sequestration effective 7/1/2022.

§  The OMB Expiration Date was revised to 8/31/2025

 

HFS will update the FQHC 224-14 system the week of November 14, 2022.

 

 

FQHC Transmittal 4

 

The FQHC, 224-14 system was updated to Transmittal 4 by CMS, on April 30, 2021. Transmittal 4 is effective for cost reporting periods that end on or after March 31, 2021.  

 

HFS was approved for Transmittal 4 on June 9, 2021. 

 

§  The primary change in Transmittal 4 was the assignment of line numbers to Worksheet S, Part II electronic signature data fields in order to capture information in the electronic cost report (ECR) file.

§  Revised Worksheet A, to subscript line 49 to separate COVID-19 vaccines and monoclonal antibody products from influenza vaccine costs.

§  Revised Worksheet B-1, to include columns to report COVID-19 vaccines and monoclonal antibody products for treatment of COVID-19.

§  The Worksheet E, sequestration adjustment instructions were also revised in accordance with §3709 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, updated with §102 of the Consolidated Appropriations Act, 2021, signed into law on December 27, 2020 temporarily suspending the 2 percent payment adjustment currently applied to all Medicare services. The suspension is effective from May 1, 2020 through March 31, 2021.  Also added line 16.25 to separately calculate non-claims based sequestration payment adjustment amounts.

 

HFS updated the FQHC 224-14 system on June 25, 2021.

 

 

FQHC Transmittal 3

 

The FQHC, 224-14 cost report was updated to Transmittal 3 by CMS, on May 3, 2019. Transmittal 3

is effective for cost reporting periods ending on or after April 30, 2019.  HFS was approved for Transmittal 3 on May 31, 2018 and the software has been released.  Transmittal 3 primarily codifies previous CMS clarifications to T-2 and also includes the following changes:

§  Extension of OMB Approval date on Worksheet S, Part I to 3-31-2022.

§  Added Worksheet E, line 13.50 for demonstration payment adjustment amounts before sequestration.

§  Added Worksheet E, line 16.50 for demonstration payment adjustment amounts after sequestration.

 

 

 

FQHC Transmittal 2

 

The FQHC, 224-14 system was updated to Transmittal 2 by CMS, on March 9, 2018. Transmittal 2 is effective for cost reporting periods ending on or after December 31, 2017. HFS was approved for Transmittal 2 on April 17, 2018 and the software has been released. The primary change in Transmittal 2 was the incorporation of a Worksheet S, check box to the certification and settlement summary statement for electronic signature submission to the FQHC cost reporting forms. This provision is available as an option for cost reporting periods ending on or after 12/31/2017 in accordance with 42 CFR 413.24(f)(4)(iv). 

 

For additional information regarding the new HFS feature incorporating the electronic signature click here. 

 

Other Transmittal 2 changes include: 

§  Added Worksheet S-1, Part I, line 28 to indicate a FQHC facility that utilizes contract labor to provide medical and/or mental health services to its patients.

§  Added Worksheet S-1, Part II, line 16 to indicate a FQHC sub facility that utilizes contract labor to provide medical and/or mental health services to its patients.

§  Modified the instructions Worksheet S-3, Part I to include visits for Transitional Care

Management (TCM) services as a medical visit if it is the only medical service provided on that day and it meets the TCM billing requirements.

 

 

 

FQHC Transmittal 1

 

On April 22, 2016, CMS published the new FQHC Cost Report, Form CMS-224-14. The new form CMS-224-14 will be effective for cost reporting periods beginning on or after October 1, 2014. This effective date reflects the implementation date of the new FQHC PPS, required under the Affordable Care Act. 

 

CMS has also issued an extension for the filing of impacted FQHC reports. Following is a table of scheduled due dates by cost report period ending: 

 

Cost Reporting Periods Beginning On or After October 1, 2014 and Ending on or Before:

Original Due Date

Revised Due Date

Extension

09/30/2015

02/29/2016

07/31/2016

153 days

10/01/2015 through 10/31/2015

03/31/2016

07/31/2016

122 days

11/01/2015 through 11/30/2015

04/30/2016

07/31/2016

92 days

12/01/2015 through 12/31/2015

05/31/2016

08/31/2016

92 days

01/01/2016 through 01/31/2016

06/30/2016

08/31/2016

62 days

02/01/2016 through 02/29/2016

07/31/2016

08/31/2016

31 days

03/01/2016 through 03/31/2016

08/31/2016

08/31/2016

0 days

 

HFS was approved for Transmittal 1 on April 22, 2016, and the update was made available to the

FQHC cost report users on April 29, 2016. Please note that if you used the HFS beta system to start 224-14 cost reports, any data entered into the beta system will be retained when you open the .mcrx file in the complete approved version of the software. 

 

HFS has been approved