Definition of Visit

FQHCs are reimbursed for medically necessary primary health services, and qualified preventive health services performed by a FQHC practitioner. Core services are reimbursed using encounter codes. A valid FQHC encounter is defined as a face-to-face, one-on-one visit between a Healthy Connections Medicaid member and a qualifying practitioner (see the Qualified Providers section) at a FQHC facility or other qualifying, nonhospital setting (refer to Place of Service allowed below). For billing purposes, SCDHHS has deemed a “visit” as an “encounter”.

All medical encounters must be billed using the appropriate encounter code unless otherwise specified. A medical “visit” (encounter) is defined as a face-to-face, one-on-one encounter between a patient and an eligible rendering provider during which a FQHC core service is provided.

A mental health visit is defined as a face-to-face, one-on-one encounter between the FQHC beneficiary and the eligible rendering provider.

SOURCE: SC Health and Human Svcs. Dept. FQHC Services Provider Manual (Dec. 2025), p. 13, 16-17. (Accessed Mar. 2026).