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pdfUniform Data System
2025 MANUAL
Health Center Data Reporting Requirements
~
Health Center Program
For Reports Due February 15, 2026
Bureau of Primary Health Care
Uniform Data System
Reporting Requirements for
2025 Health Center Data
PUBLIC BURDEN STATEMENT
The Uniform Data System (UDS) provides consistent information about health centers including patient characteristics, services provided, clinical processes
and health outcomes, patients’ use of services, costs, and revenues. It is the source of unduplicated data for the entire scope of services included in the grant
or designation for the calendar year. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it
displays a currently valid Office of Management and Budget (OMB) control number. The OMB control number for this project is 0915-0193 and it is valid
until 04/30/2026. This information collection is mandatory under the Health Center Program authorized by section 330 of the Public Health Service (PHS)
Act (42 U.S.C. 254b). Public reporting burden for this collection of information is estimated to average 238 hours per response, including the time for
reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Health Resources and Services
Administration (HRSA) Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B, Rockville, Maryland, 20857 or paperwork@hrsa.gov.
DISCLAIMER
“This publication lists non-federal resources to provide additional information to consumers. Neither the U.S. Department of Health and Human Services
(HHS) nor the Health Resources and Services Administration (HRSA) has formally approved the non-federal resources in this manual. Listing these is not
an endorsement by HHS or HRSA.”
Bureau of Primary Health Care
Uniform Data System Reporting
Requirements
For Calendar Year 2025 UDS Data
For help contact: 866-837-4357 (866-UDS-HELP), BPHC Contact Form,
https://bphc.hrsa.gov/datareporting/reporting/index.html, or udshelp330@bphcdata.net
Health Resources and Services Administration
Bureau of Primary Health Care
5600 Fishers Lane, Rockville, Maryland 20857
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2025 Uniform Data System Manual Contents
2025 Uniform Data System Manual Contents . 4
Changes and Highlights to the Reporting
Requirements ...................................................... 9
Introduction ...................................................... 10
About the UDS ............................................... 10
What This Manual Includes............................ 10
General Instructions ......................................... 11
What to Submit ............................................... 11
What Is Included............................................. 11
Calendar Year Reporting ................................ 12
Patients by ZIP Code Table ............................ 27
Instructions for Tables 3A and 3B .................. 28
Table 3A: Patients by Age and by Sex –
Instructions ....................................................... 28
Table 3B: Demographic Characteristics –
Instructions ....................................................... 29
Patients by Hispanic, Latino/a, or Spanish Ethnicity
and Race (Lines 1–8)...................................... 29
Hispanic, Latino/a, or Spanish Ethnicity .... 29
Race ............................................................ 31
In-Scope Reporting......................................... 13
Patients Best Served in a Language Other than
English (Line 12)............................................ 32
Due Dates and Revisions to Reports .............. 13
FAQ for Tables 3A and 3B ............................ 32
How and Where to Submit Data ..................... 13
Table 3A: Patients by Age and by Sex ........... 35
FAQ for the General Instructions ................... 15
Table 3B: Demographic Characteristics......... 36
Instructions for Tables That Report ............... 17
Visits, Patients, and Providers ......................... 17
Instructions for Table 4: Selected Patient
Characteristics .................................................. 38
Countable Visits ............................................. 17
Documentation ........................................... 17
Independent Professional Judgment ........... 18
Behavioral Health Group Visits ................. 18
Location of Services Provided.................... 18
Counting Multiple Visits by Category of Service
.................................................................... 19
Patient ............................................................. 19
Services and Individuals NOT Reported on the
UDS Report ................................................ 20
Provider .......................................................... 21
FAQ for the Instructions for Tables ............... 22
Instructions for Patients by ZIP Code Table . 23
Patients by ZIP Code ...................................... 23
ZIP Code of Specific Groups ..................... 23
Unknown ZIP Code .................................... 24
Ten or Fewer Patients in ZIP Code ............ 24
Instructions for Patients by Medical Insurance24
Insurance Categories .................................. 24
FAQ for Patients by ZIP Code Table ............. 25
4
2025 UDS MANUAL | Table of Contents
Income as a Percentage of Poverty Guideline, Lines
1–6 .................................................................. 38
Primary Third-Party Medical Insurance, Lines 7–12
........................................................................ 38
None/Uninsured (Line 7) ........................... 39
Medicaid (Line 8a) ..................................... 39
CHIP Medicaid (Line 8b) ........................... 40
Medicare (Line 9) ....................................... 40
Dually Eligible (Medicare and Medicaid) (Line
9a) ............................................................... 40
Other Public Insurance (Non-CHIP) (Line 10a)
.................................................................... 40
Other Public Insurance CHIP (Line 10b) ... 41
Private Insurance (Line 11) ........................ 41
Managed Care Utilization, Lines 13a–13c ..... 41
Member Months ......................................... 42
Special Medically Underserved Populations, Lines
14–26 .............................................................. 43
Total Migratory and Seasonal Agricultural
Workers and Their Family Members, Lines 14–
16 ................................................................ 43
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Total Homeless Population, Lines 17–23 ... 44
Total School-Based Service Site Patients, Line
24 ................................................................ 46
Total Veterans, Line 25 .............................. 46
Total Residents of Public Housing, Line 26..47
Selected Diagnoses, Lines 1–20f ................... 76
Selected Diagnoses Visits and Patients, Columns
A and B ...................................................... 76
FAQ for Table 4 ............................................. 47
Selected Tests/Screenings, Lines 21–26e ....... 77
Table 4: Selected Patient Characteristics........ 51
Selected Tests/Screenings Visits and Patients,
Columns A and B ....................................... 77
Table 4: Selected Patient Characteristics
(continued)...................................................... 52
Instructions for Table 5: Staffing and Utilization
............................................................................ 53
Dental Services, Lines 27–34 ......................... 78
Dental Services Visits and Patients, Columns A
and B .......................................................... 78
Table 5: Staffing and Utilization .................... 53
Services Provided by Multiple Entities .......... 79
Personnel FTEs, Column A ............................ 53
FAQ for Table 6A .......................................... 79
Identifying Employment Type and Calculating
FTEs ........................................................... 54
Table 6A: Selected Diagnoses and Services
Rendered ........................................................ 84
Reporting FTEs on the Appropriate Line on
Table 5 ........................................................ 54
Selected Diagnoses......................................... 84
Personnel by Major Service Category ........ 55
Sources of Codes ............................................ 88
Visits, Columns B and B2 .............................. 62
Instructions for Tables 6B and 7 ..................... 89
Clinic Visits, Column B ............................. 62
Column Logic Instructions ............................. 89
Virtual Visits, Column B2 .......................... 62
Visits Purchased from Non-Personnel Providers
on a Fee-For-Service Basis ......................... 63
Visit Considerations by Personnel Line ..... 64
DO NOT Report Visits or Patients for Services
Provided by the Following: ........................ 66
Patients, Column C ......................................... 66
Selected Service Detail Addendum – Instructions
........................................................................ 67
Providers, Column A1 ................................ 68
Selected Services Rendered ........................... 86
Column A (A, 2A, or 3A): Number of Patients in
the Denominator ......................................... 89
Column B (B, 2B, or 3B): Number of Records
Reviewed .................................................... 90
Column C (C or 2C) or 3F: Number of
Charts/Records Meeting the Numerator Criteria
.................................................................... 91
And vs. Or .................................................. 91
Detailed Instructions for Clinical Quality Measures
........................................................................ 91
Clinic Visits, Column B ............................. 68
Instructions for Table 6B: Quality of Care
Measures ........................................................... 93
Virtual Visits, Column B2 .......................... 68
Table 6B: Quality of Care Measures .............. 93
Patients, Column C ..................................... 68
Sections A and B: Demographic Characteristics of
Prenatal Care Patients..................................... 94
FAQ for Table 5 and Selected Service Detail
Addendum ...................................................... 68
Table 5: Staffing and Utilization .................... 73
Table 5: Staffing and Utilization (continued) . 74
Table 5: Selected Service Detail Addendum .. 75
5
Instructions for Table 6A: Selected Diagnoses..76
and Services Rendered ..................................... 76
2025 UDS MANUAL | Table of Contents
Prenatal Care by Referral Only (check box)94
Section A: Age of Prenatal Care Patients (Lines
1–6) ............................................................ 94
Section B: Early Entry into Prenatal Care (Lines
7–9), No eCQM .......................................... 95
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Sections C through M: Other Quality of Care
Measures ......................................................... 96
Childhood Immunization Status (Line 10),
CMS117v13................................................ 97
Cervical Cancer Screening (Line 11),
CMS124v13.............................................. 100
Breast Cancer Screening (Line 11a),
CMS125v13.............................................. 101
Section A: Deliveries and Birth Weight ....... 130
HIV-Positive Pregnant Women, Top Line (Line 0)
...................................................................... 130
Deliveries Performed by Health Center Provider
(Line 2) ......................................................... 130
Deliveries and Birth Weight Data by Race and
Hispanic, Latino/a, or Spanish Ethnicity, Columns
1a–1d ............................................................ 130
Weight Assessment and Counseling for Nutrition
and Physical Activity for Children/Adolescents
(Line 12), CMS155v13 ............................. 103
Prenatal Care Patients and Referred Prenatal
Care Patients Who Delivered During the Year
(Column 1a).............................................. 130
Preventive Care and Screening: Body Mass
Index (BMI) Screening and Follow-Up Plan
(Line 13), CMS69v13 ............................... 104
Birth Weight of Infants Born to Prenatal Care
Patients Who Delivered During the Year
(Columns 1b–1d) ...................................... 131
Preventive Care and Screening: Tobacco Use:
Screening and Cessation Intervention (Line 14a),
CMS138v13.............................................. 106
Statin Therapy for the Prevention and Treatment
of Cardiovascular Disease (Line 17a),
CMS347v8................................................ 107
Ischemic Vascular Disease (IVD): Use of Aspirin
or Another Antiplatelet (Line 18), CMS164v7
.................................................................. 109
Colorectal Cancer Screening (Line 19),
CMS130v13.............................................. 110
HIV Linkage to Care (Line 20), No eCQM112
Sections B and C: Other Health Outcome Measures
...................................................................... 132
Controlling High Blood Pressure (Columns 2a–
2c), CMS165v13 ...................................... 132
Diabetes: Glycemic Status Assessment Greater
Than 9% (Columns 3a–3f), CMS122v13. 134
FAQ for Table 7 ........................................... 135
Table 7: Health Outcomes ............................ 137
Instructions for Table 8A: Financial Costs .. 149
Table 8A: Financial Costs ............................ 149
Column Reporting Requirements ................. 149
HIV Screening (Line 20a), CMS349v7 .... 113
Column A: Accrued Costs........................ 149
Preventive Care and Screening: Screening for
Depression and Follow-Up Plan (Line 21),
CMS2v14.................................................. 114
Column B: Allocation of Facility Costs and NonClinical Support Service Costs ................. 149
Depression Remission at Twelve Months (Line
21a), CMS159v13..................................... 116
Dental Sealants for Children between 6–9 Years
(Line 22), CMS277v0 ............................... 118
Column C: Total Cost After Allocation of
Facility and Non-Clinical Support Services149
Cost Center Line Reporting Requirements .. 150
Medical Personnel Costs (Line 1) ............ 150
Initiation and Engagement of Substance Use
Disorder Treatment (Lines 23a and 23b),
CMS137v13.............................................. 119
Medical Lab and X-Ray Costs (Line 2) ... 150
FAQ for Table 6B......................................... 120
Other Clinical Services (Lines 5–10) ....... 151
Table 6B: Quality of Care Measures ............ 125
Dental (Line 5) ......................................... 151
Instructions for Table 7: Health Outcomes .. 129
Mental Health (Line 6) ............................. 151
Table 7: Health Outcomes Measures ............ 129
Substance Use Disorders (Line 7) ............ 151
Race and Ethnicity Reporting ....................... 129
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2025 UDS MANUAL | Table of Contents
Other Direct Medical Costs (Line 3) ........ 151
Total Medical (Line 4) ............................. 151
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Pharmacy (Not Including Pharmaceuticals) (Line
8a) ............................................................. 152
Column D: Adjustments ........................... 168
Pharmaceuticals (Line 8b) ........................ 152
Column F: Bad Debt Write-Off................ 169
Other Professional (Line 9) ...................... 152
Total Patient Service Revenue (Line 14) . 170
Vision (Line 9a) ........................................ 152
FAQ for Table 9D ........................................ 170
Total Other Clinical (Line 10) .................. 153
Table 9D: Patient Service Revenue .............. 172
Enabling (Lines 11a–11h, 11) .................. 153
Instructions for Table 9E: Other Revenue... 174
Total Enabling Services (Line 11) ............ 153
Table 9E: Other Revenue ............................. 174
Other Program-Related (Line 12) ............. 153
HRSA’s BPHC Grants ................................. 174
Quality Improvement (QI) (Line 12a) ...... 154
Total Enabling, Other Program-Related, and
Quality Improvement Services (Line 13) . 154
Column E: Sliding Fee Discounts ............ 169
Health Center Program Grants, Lines 1a Through
1e .............................................................. 174
Total Health Center Program (Line 1g) ... 175
Facility Costs (Line 14) ............................ 154
Capital Development Grants (Line 1k) .... 175
Non-Clinical Support Services Costs (Line 15)
.................................................................. 154
COVID-19 Supplemental Funding........... 175
Total Facility and Non-Clinical Support Services
(Line 16) ................................................... 155
Total Accrued Costs (Line 17) ................. 155
Value of Donated Facilities, Services, and
Supplies (Line 18, Column C) .................. 155
Total with Donations (Line 19) ................ 156
Column B: Facility and Non-Clinical Support
Services Allocation Instructions ................... 156
Facility ...................................................... 156
Non-Clinical Support Services ................. 157
FAQ for Table 8A ........................................ 157
Table 8A: Financial Costs ............................ 160
Total HRSA’s BPHC Grants (Line 1) ....
.... 175
Other Federal Grants .................................... 176
Ryan White Part C—HIV Early Intervention
Grants (Line 2) ......................................... 176
Other Federal Grants (Line 3) .................. 176
Promoting Interoperability Program (Line 3a)
.................................................................. 176
Total Other Federal Grants (Line 5) ......... 176
Non-Federal Grants or Contracts ................. 177
State Government Grants and Contracts (Line 6)
.................................................................. 177
State/Local Indigent Care Programs (Line 6a)
.................................................................. 177
Instructions for Table 9D: Patient Service Revenue
.......................................................................... 162
Local Government Grants and Contracts (Line 7)
.................................................................. 177
Table 9D: Patient Service Revenue .............. 162
Foundation/Private Grants and Contracts (Line 8)
.................................................................. 177
Rows: Payer Categories and Form of Payment162
Payer Categories ....................................... 163
Form of Payment ...................................... 165
Columns: Charges, Payments, and Adjustments
Related to Services Delivered ...................... 165
Other Revenue (Line 10) .......................... 178
Column A: Full Charges This Period ....... 165
FAQ for Table 9E......................................... 178
Column B: Amount Collected This Period166
Table 9E: Other Revenues............................ 180
Columns C1–C4: Retroactive Settlements,
Receipts, or Paybacks ............................... 167
7
Total Non-Federal Grants and Contracts (Line 9)
.................................................................. 177
2025 UDS MANUAL | Table of Contents
Total Other Revenue (Line 11) ................ 178
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Appendix A: Listing of Personnel ................. 181
Appendix B: Special Multi-Table Situations..186
Relationship Between Insurance on Table 4 and
Revenue on Table 9D ................................... 199
Contracted Care ............................................ 187
Relationship Between Prenatal Care on Table 6B
and Deliveries on Table 7............................. 199
Services Provided by a Volunteer Provider .. 188
Interns and Residents.................................... 188
Women, Infants, and Children (WIC) .......... 189
In-House Pharmacy or Dispensary Services for
Health Center Patients .................................. 190
In-House Pharmacy for Community (i.e., for nonpatients) ........................................................ 191
Contract Pharmacy Dispensing to Health Center
Patients, Generally Using 340B Purchased Drugs
...................................................................... 191
Appendix C: Reduced Number of Records
Reviewed for Clinical Quality Measure Reporting
.......................................................................... 202
Appendix D: Health Center Health Information
Technology (Health IT) Capabilities ............ 203
Introduction .................................................. 203
Questions ...................................................... 203
Donated Drugs, Including Vaccines ............. 192
FAQ for Appendix D: Health Center Health IT
Capabilities Form ......................................... 208
Clinical Dispensing of Drugs ....................... 192
Appendix E: Other Data Elements ............... 210
ADHC and PACE ......................................... 193
Introduction .................................................. 210
Medi-Medi/Dually Eligible .......................... 193
Questions ...................................................... 210
Certain Grant-Supported Clinical Care Programs
...................................................................... 194
FAQ for Appendix E: Other Data Elements Form
...................................................................... 212
State or Local Indigent Care Programs......... 194
Appendix F: Workforce ................................. 213
Workers’ Compensation ............................... 194
Introduction .................................................. 213
Tricare, Trigon, and Public Employees’ Insurance
...................................................................... 195
Questions ...................................................... 213
School-based Sites ........................................ 195
The Children’s Health Insurance Program (CHIP)
...................................................................... 196
Carve-Outs.................................................... 196
Patients Served in a Carceral Facility ........... 197
Health IT/EHR Personnel and Costs ............ 197
New Start or New Access Point (NAP) ........ 198
Relationship Between Personnel on Table 5 and
Costs on Table 8A ........................................ 198
8
Relationship Between Race and Ethnicity on Tables
3B and 7 ....................................................... 200
2025 UDS MANUAL | Table of Contents
Appendix G: Health Center Resources ........ 216
UDS Production Timeline and Report Availability
...................................................................... 217
Publicly Available UDS Data ...................... 218
UDS CQMs and National Programs Crosswalk.218
Appendix H: Glossary.................................... 221
Appendix I: Acronyms ................................... 226
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Changes and Highlights to the Reporting Requirements
Key changes from the 2024 calendar year reporting to the 2025 calendar year reporting are included at the start of
each Table and Form instruction section and highlighted in honeycomb color for ease of locating.
Note: Items highlighted in ice blue emphasize key foundational reporting guidance.
9
2025 UDS MANUAL | Changes to the Reporting Requirements
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Introduction
This manual describes the annual Uniform Data System (UDS) reporting requirements for all health centers that
receive federal award funds (“awardees”) under the Health Center Program authorized by section 330 of the
Public Health Service (PHS) Act (42 U.S.C. 254b) (“section 330”), as amended (including sections 330(e), (g),
(h), and (i)), as well as for health centers considered Health Center Program look-alikes. Look-alikes DO NOT
receive federal funding under section 330 of the PHS Act (although they may receive funding during public health
emergencies), but they do meet the Health Center Program requirements for designation under the program (42
U.S.C. 1395x(aa)(4)(A)(ii) and 42 U.S.C. 1396d(l)(2)(B)(ii)). Certain health centers funded under HRSA’s
Bureau of Health Workforce (BHW) are also required to submit a UDS Report.
Unless otherwise noted, for the rest of this manual the term “health center” will refer to all the entities listed
above that are required to submit a UDS Report.
ABOUT THE UDS
The UDS is a standard data set that is reported annually by each health center and, thus, provides consistent
information about health centers. This core set of information for the calendar year includes patient
characteristics, services provided, clinical processes and health outcomes, patients’ use of services, staffing, costs,
and revenues. It is the source of unduplicated data for the entire scope of services included in the grant or
designation for the calendar year 2025.
•
If the health center brings services into its approved scope of project at any time during the calendar year, the
health center must include data for those services in its UDS Report for the full calendar year.
•
If the health center brings service delivery sites into its approved scope of project during the calendar year, the
health center must include data for the new service delivery sites in its UDS Report for the period beginning
on the date of the scope change or the New Access Point (NAP) site implementation date.
HRSA routinely reports these data and related analyses, making them available to health centers in HRSA’s
Electronic Handbooks (EHBs) and to the public through HRSA’s data.HRSA.gov website.1 Please refer to
Appendix G: Health Center Resources for resources that may be helpful for completing the UDS Report.
WHAT THIS MANUAL INCLUDES
This manual includes reporting requirements and resources to help with completion of the calendar year 2025
UDS Report due February 15, 2026.
Reporting requirements include the
approved UDS changes for the
calendar year. The 2025 Program
Assistance Letter (PAL) provides an
overview of key changes.
A list of personnel by service
category and by job title who may be
eligible to produce countable “visits”
for the UDS is shown in Appendix A.
Issues that affect multiple tables are
addressed in Appendix B.
Reduced denominator
considerations for clinical quality
measure (CQM) reporting are
provided in Appendix C.
Resources and supports to assist health
centers, including links to electronic
clinical quality measures (eCQMs), are
provided in Appendix G.
A glossary of key terms is available
in Appendix H.
1
Acronyms used throughout the UDS
Manual are defined in Appendix I.
In accordance with the Freedom of Information Act (Exemption 4), HRSA’s BPHC does not publicly share proprietary business information at the health
center level.
10
2025 UDS MANUAL | Introduction
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General Instructions
WHAT TO SUBMIT
The UDS includes two parts that health centers are required to submit through the Electronic Handbooks (EHBs):
1) All health centers use the Universal Report, which consists of the UDS tables, the Health Information
Technology (Health IT) Form, the Other Data Elements Form, and the Workforce Form.
The Universal Report is an unduplicated count of all patients served by the health center regardless of funding
source; the Grant Report is a subset of the patients reported on the Universal Report who are served under a
special medically underserved population funding authority. Thus, no cell in a Grant Report may have a
number larger than the same cell in the Universal Report.
2) Health Center Program awardees that receive section 330 grants under multiple funding authorities
(Community Health Center [CHC] [330(e)] funding, Migratory and Seasonal Agricultural Workers [MSAW]
[330(g)] funding, Homeless Population [HP] [330(h)] funding, and/or Residents of Public Housing [RPH]
[330(i)] funding) also complete separate Grant Reports.
•
The Grant Reports provide data comparable to the Universal Report for Tables 3A, 3B, 4, 6A, and part of
Table 5.
•
Grant Reports are only completed for the portion of the program that falls within the scope of a project funded
under a particular funding authority.
•
The vast majority of health centers have a CHC (330(e)) grant, and to report a separate grant report would add
burden to health centers, since these activities make up a large portion of the Universal Report. Therefore,
awardees with grants from multiple 330 funding streams DO NOT submit a separate Grant Report for the
scope of project supported by CHC (330(e)) funding.
Report all the data for any patient who receives services under sections 330(g), (h), or (i) in the proper Grant
Report. Include all services provided to these patients regardless of the funding source.
The EHBs reporting system automatically identifies and provides forms for all the reports needed to meet the
reporting requirements. Please contact Health Center Program Support through the BPHC Contact Form or at
877-464-4772 if there appear to be errors.
WHAT IS INCLUDED
The UDS includes 11 tables and 3 forms that provide demographic, clinical, operational, and financial data.
Health centers must complete the following:
Table
Data Reported
Service Area
Service Area
Patients by ZIP Code Table:
Patients by ZIP Code
Patients served reported by ZIP code and by primary
third-party medical insurance source, if any
Patient Profile
Patient Profile
Table 3A: Patients by Age and by
Sex
Table 3B: Demographic
Characteristics
11
Universal
Report
Service Area
Grant
Reports
Service
Area
X
Not included in grant reports
Patient Profile
Patient
Profile
Patients by age and by sex
X
X
Patients by race, ethnicity, and language preference
X
X
2025 UDS MANUAL | General Instructions
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Table
Data Reported
Patients by income (as measured by percentage of the
federal poverty guidelines [FPG]) and primary thirdparty medical insurance; the number of “special
medically underserved population” patients receiving
services; and managed care enrollment, if any
Staffing and Utilization
The annualized full-time equivalent (FTE) of program
personnel by position, in-person and virtual visits by
provider type, and patients by service type
Mental health services provided by medical providers;
substance use disorder (SUD) services provided by
medical and mental health providers
Clinical
Visits and patients for selected medical, mental health,
SUD, vision, and dental diagnoses and services
Table 4: Selected Patient
Characteristics
Staffing and Utilization
Table 5: Staffing and Utilization
Table 5 Addendum: Selected
Service Detail Addendum
Clinical
Table 6A: Selected Diagnoses and
Services Rendered
Table 6B: Quality of Care
Measures
Table 7: Health Outcomes
Financial
Table 8A: Financial Costs
Table 9D: Patient Service
Revenue
Table 9E: Other Revenue
Other
Appendix D: Health Information
Technology (Health IT)
Capabilities Form
Clinical quality of care measures
Universal
Report
Grant
Reports
X
X
Staffing and Utilization
Staffing and Utilization
X
Partial
(excludes
FTE)
X
Not included in grant reports
Clinical
Clinical
X
X
X
Not included in grant reports
Health outcome measures
X
Financial
Direct and indirect expenses by cost categories
X
Full charges, collections, and adjustments by payer type;
X
sliding fee discounts; and patient bad debt write-offs
Other, non–patient service revenue
X
Other Form
Health IT capabilities, including the use of electronic
health record (EHR) information, and health-related
X
needs
Medications for opioid use disorder (MOUD), telehealth,
Appendix E: Other Data Elements
outreach and enrollment assistance, and voluntary family
X
Form
planning
Health center workforce training and use of satisfaction
Appendix F: Workforce Form
X
surveys for provider and other personnel
Note: Grant reports are NOT completed for tables and forms that are grayed out in the last column of this table.
Financial
Other Form
Not included in grant reports
Financial
Not included in grant reports
Not included in grant reports
Not included in grant reports
Other Form
Not included in grant reports
Not included in grant reports
Not included in grant reports
The UDS Support Center is available to provide training, technical assistance, and resources about the UDS data
and reporting requirements. Contact the Support Center at 1-866-UDS-HELP, udshelp330@bphcdata.net, or
BPHC Contact Form.
CALENDAR YEAR REPORTING
Who Reports UDS
• All health centers funded
or designated, in whole
or in part, before
October 1, 2025,
including New Access
Point (NAP) awardee
recipients, mergers, or
acquisitions.
12
What Is Reported
How to Report
• Approved in-scope
activities from January
1 through December
31, 2025.
• Through the Electronic
Handbooks (EHBs)
starting January 1,
2026.
• Report even if no grant
funds were drawn down
for some or all funding
streams during the
calendar year.
• Preliminary Reporting
Environment (PRE) and
offline tools are available
in Fall 2025.
2025 UDS MANUAL | Instructions for Tables
When to Report
• January 1 through
February 15, 2026.
UDS Reports are to be
submitted by February
15, 2026.
• UDS Report reviews are
conducted and necessary
revisions are made from
February 15 through
March 31, 2026.
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The UDS is a calendar year report. Health centers—including all those whose designation or funding begins,
either in whole or in part, on or after January 1—must report in-scope activities for the entire calendar year.
Similarly, health centers with a fiscal year or grant period other than January 1 to December 31 will still report on
the calendar year, NOT on their fiscal or grant year.
If an entire look-alike program became funded and converted to a 330 awardee before October 1, 2025, report
only an awardee UDS Report for the year.
Health centers whose designation or funding ends during the year are still obligated to fulfill reporting
requirements for the calendar year. Health centers are to contact Health Center Program Support via the BPHC
Contact Form or at 877-464-4772 to clarify their reporting requirements.
No UDS Report is filed if the health center was funded or designated for the first time on or after October 1 of
the calendar year.
IN-SCOPE REPORTING
All health centers must submit data that reflects all activities in the HRSA health center scope of project, as
defined in approved applications and reflected in the official Notice of Award/Designation.
For organizations that operate programs and/or service delivery sites that are out of scope, limit the reporting to
the approved scope of project only.
DUE DATES AND REVISIONS TO REPORTS
The period for submission of complete and accurate UDS Reports through EHBs is January 1 through February
15, 2026, 11:59 p.m. local time.
From February 15 through March 31, 2026, a Health Center Program UDS Reviewer will review your report and,
as needed, help you in ensuring that reported data adheres to reporting requirements. The UDS Reviewer sends
communications and data change requests through EHBs via a non-HRSA.gov email address to the health center
contact listed in the EHBs. Communicate directly with the assigned UDS Reviewer during this time to address
questions they have raised. It is critical to address questions raised by your UDS Reviewer within the timeframe
assigned in order to meet the final submission timeline. Final, corrected submissions are due no later than March
31, 2026.
HRSA may grant a reporting exemption under extraordinary circumstances, such as the physical destruction of a
health center. Health centers must request such exemptions directly from HRSA’s BPHC via the BPHC Contact
Form or at 877-464-4772.
HOW AND WHERE TO SUBMIT DATA
All health centers are to submit a full UDS Report within EHBs by February 15, 2026. This will be the official
submission of record for 2025 reporting. To log in to the EHBs, use your Login.gov account and two-factor
authentication. Visit the EHBs Help and Knowledge Base for more information on Login.gov.
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Health center personnel need a username and password to log into the EHBs, which are then used to access,
complete, and submit the health center’s UDS Report. The EHBs supports standard web browsers2 and provides
electronic forms necessary to complete the UDS Report. The PRE provides early access to the EHBs and is
available in the fall. This allows health centers to:
•
enter available UDS data,
•
identify potential data reporting problems, and
•
make use of additional preparation time to compile UDS data.
Note: Data present in the PRE on December 31 are automatically transferred to the annual UDS reporting
environment, which opens January 1.
To facilitate a team-based approach, there are also offline reporting templates available within the EHBs. For
more information on these tools, visit the UDS Training and Technical Assistance Reporting Guidance webpage.
Health centers are required to appoint one person as the UDS contact. The UDS contact receives all
communications about the UDS Report. This person ensures that the report is submitted according to set
deadlines, corrections to the report are made, and explanations of accurate data reported on the UDS tables are
clear. Be sure the UDS contact information in the EHBs is current to ensure receipt of important UDSrelated communications.
Health centers grant individual personnel “view” or “edit” privileges in the EHBs. These privileges apply to the
whole report, not just specific tables or forms. Health centers may give edit privileges to several people, each
using separate, individualized login credentials. Health center personnel with EHBs access can work on the tables
and forms in sections, saving interim or partial versions online as they work and returning to complete them later.
The EHBs saves user progress as the health center completes all tables and runs system checks on the data until
the health center makes a formal submission. To verify accuracy, the EHBs checks for potential inconsistencies or
questionable data. The system provides a summary of which tables are complete and a list of audit questions.
Health center personnel must address each of the data audit findings, even if the audit question does not appear to
apply to their health center’s unique circumstances. If personnel believe the data are correct as reported, they
should clearly explain any unique circumstances with the yearly UDS submission in table comments. The chief
executive officer (CEO) or project director usually submits, but they may delegate the authority to someone else
by designating an alternate in the EHBs. At the time of submission, the UDS requires the submitter to
acknowledge that the health center reviewed and verified the accuracy and validity of the data. Submit only
complete and accurate reports into the EHBs.
2
While most web browsers should work with the EHBs, it is certified to work with the browsers mentioned in the EHBs’ recommended settings, which are
available on the EHBs website.
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Failure to submit a timely, accurate, and complete UDS Report by February 15, 2026, 11:59 p.m. (local
time) may result in a condition being placed on your grant award. Additional restrictions, including the
requirement that all drawdowns of Health Center Program grant award funds from the Payment Management
System (PMS) have the prior approval of the HRSA Division of Grants Management Operations (DGMO) and/or
limits on future funding (e.g., base adjustments), may also be placed on your grant award.
Note: Retain health center UDS reporting backup documentation and files for a minimum of 1 year or through a
later date determined by the health center.
Please refer to Appendix G: Health Center Resources for resources that may be helpful for completing the UDS
Report.
FAQ FOR THE GENERAL INSTRUCTIONS
1. Do we report only the services provided to patients using HP, MSAW, or RPH grant funds on the
Grant Report?
No. Include activity for all patients described in the approved HP, MSAW, or RPH grant scope of project,
regardless of the funding source. For example, if patients experiencing homelessness receive medical services
in the 330(h)-supported homeless medical van, report this activity on the Homeless Population Grant Report
tables. If patients experiencing homelessness receive dental services at the clinic, where 330(h) funds are not
used, this activity would also be reported on the Homeless Population Grant Report tables regardless of the
dental funding source.
2. When do we complete a Universal Report and when do we complete a Grant Report?
In summary, health centers that receive funds under only one of HRSA’s BPHC Health Center Program
awards complete the Universal Report and no Grant Reports (CHC only, HP only, MSAW only, or RPH
only). Additionally, look-alikes and certain health centers funded by BHW complete the Universal Report and
no Grant Reports. Health centers funded through multiple of HRSA’s BPHC funding authorities complete a
Universal Report for the combined projects and a separate Grant Report for activity covered by their MSAW,
HP, and/or RPH funding grant(s), but not their CHC funding grant.
Examples include the following:
•
A CHC awardee that also has HP funding completes a Universal Report for all in-scope activity and a
Grant Report for activity under the HP funding, but it does NOT complete a Grant Report for the CHC
funding.
•
A CHC awardee that also has MSAW and HP funding completes a Universal Report, a Grant Report for
the HP funding, and a Grant Report for the MSAW funding.
•
An HP awardee that also receives RPH funding completes a Universal Report and two Grant Reports—
one for the HP funding and one for the RPH funding.
•
An HP awardee that receives no other Health Center Program funding will file a Universal Report and
will NOT file a Grant Report.
3. We had a service delivery site that closed and services that were removed during the calendar year, and
they are no longer in-scope. Do we report data from the service delivery site or services that were
removed from the scope of project on the UDS Report?
Yes. If services or service delivery sites are removed from your scope of project during the calendar year,
report on all activities (patients, services, visits, clinical care, personnel, revenue, and costs) up until the date
HRSA acknowledged their removal from your approved scope of project.
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4. We added a new service delivery site to our scope of project. What should we do to report the activity
of this new service delivery site on the UDS Report?
Health centers must submit data for all approved in-scope activities, as reflected in the Notice of
Award/Designation when a new service delivery site is added, as listed on Form 5B: Service Sites. If your
health center added a new service delivery site, either through a change in scope (CIS) request or through an
NAP award, you will be required to submit data for approved in-scope activities based on your CIS approval
date and/or NAP site implementation date.
5. Is activity at a non-approved service delivery site included on the UDS Report?
No. Only report services provided at your health center’s approved service delivery sites (e.g., clinics,
schools, homeless shelters), as listed on Form 5B, or in other locations that DO NOT meet HRSA’s site
criteria but are included in the health center’s approved scope of project (e.g., hospitals, nursing homes,
extended care facilities, patient’s home), as shown on Form 5C: Other Activities/Locations.
6. What should we do if a data breach impacts our ability to complete an accurate UDS Report by
February 15?
Health centers are still required to complete the UDS Report to the best of their ability with the data they
have. Contact Health Center Program Support via the BPHC Contact Form, udshelp330@bphcdata.net, or at
877-464-4772 to discuss the circumstances of the breach. Additionally, clearly explain missing data and its
impact on any affected tables using the EHBs UDS Report Comment field.
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Instructions for Tables That Report
Visits, Patients, and Providers
Health centers serve many individuals in different ways. NOT all individuals and their encounters are reported in
the UDS Report, and not all health center personnel count as providers. The following section defines countable
visits, patients, and providers for the UDS.
COUNTABLE VISITS
Visits determine who to count as a patient on the Patients by ZIP Code Table and Tables 3A, 3B, 4, 5, 6A, 6B,
and 7, and in the corresponding activity reported throughout the UDS Report. Report visits by type of provider on
Table 5 and for selected diagnoses and selected services on Table 6A.
Countable visits are encounters between a patient and a licensed or credentialed provider who exercises
independent professional judgment in providing services that are:
•
documented,
•
individualized,3
•
in-person or virtual.4
Count only visits that meet all these criteria.
Services must be provided by an individual classified as a “provider” for purposes of counting visits. Not all
health center personnel who interact with patients qualify as a provider, and not all services by a provider are
countable visits. See Services and Individuals NOT Reported on the UDS Report. Appendix A provides a list of
various health center personnel and the status of each as a provider or non-provider for UDS reporting purposes.
In addition to visits provided by health center providers, visits provided by contractors who are paid for by or
billed through the health center are counted in the UDS if they meet all visit criteria. These include outpatient
or inpatient specialty care associated with a managed care contract. In these instances, if the visit is not fully
documented in the patient’s health record, a summary of the visit must appear in the patient’s health record,
including all appropriate documentation and coding. Generally, at a minimum, this will include procedure and
diagnostic codes.
Below are definitions and criteria for reporting visits. Table 5 provides further clarifications. See Clinic Visits,
Column B.
Documentation
Health centers must record the service and associated patient information, in print or electronic form, in a system
that permits ready retrieval of current data for the patient. The patient health record does not have to be complete
with all details of the service to meet this standard, but it should generally include service code(s), setting of
3
An exception is allowed for behavioral health visits, which may be conducted in a group setting.
Only interactive, synchronous audio and/or video telecommunication systems that permit real-time communication between a distant provider and a
patient may be considered and coded as telemedicine services. The term “telehealth” includes telemedicine services but encompasses a broader scope of
remote health care services. Telemedicine is specific to remote clinical services, whereas telehealth may include remote non-clinical services, such as
provider training, administrative meetings, and continuing medical education, in addition to clinical services.
4
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service, decision making of necessity and appropriateness, examination or assessment, and time spent on the date
of visit.
Independent Professional Judgment
Providers must be acting on their own, not assisting another provider, when serving the patient.
Independent professional judgment is the use of the professional skills gained through formal training and
experience and unique to that provider or other similarly or more intensively trained providers.
Behavioral Health Group Visits
Behavioral health (mental health or substance use disorder [SUD]) visits are the only type of visit that may be
counted when conducted in a group setting. A health center may count visits by a behavioral health provider who
provides service(s) to a group of patients simultaneously only if the service(s) is/are documented in each patient’s
health record.
Examples of “group visits” include family therapy or counseling sessions, group mental health counseling, and
group SUD counseling where several people receive services that are documented in each patient’s health record.
Other considerations:
•
The health center normally records applicable charges for each patient, even if another grant or contract
covers the costs.
•
If only one patient is billed (for example, when a family member who is not the patient takes part in a
patient’s counseling session), count the visit for only that one patient.
•
DO NOT count group medical or health education visits.
Location of Services Provided
A visit must take place in health centers’ approved service delivery sites (e.g., clinics, schools, homeless shelters,
transitional care in carceral setting locations as listed on Form 5B) or in other locations that DO NOT meet
HRSA’s site criteria but are included in the health center’s scope of project (e.g., hospitals, nursing homes,
extended care facilities, patient’s home), as referenced on Form 5C. In addition, virtual visits may occur from
other locations. See instructions for Virtual Visits.
Inpatient visit considerations:
•
Count only one inpatient visit per patient per service category per day, regardless of how many clinic
providers see the patient or how often they do so.
•
Visits include encounters with an existing patient who has been hospitalized, when health center medical
personnel “follow” the patient during the hospital stay as the provider of record or when they provide care to
the patient on behalf of the provider of record. This applies only when the health center pays their medical
personnel who “follow” patients (or insurance) for the specific service.
•
When a patient’s first encounter is in a hospital, in respite care, or in a similar facility that is not specifically
approved in Form 5B as a service delivery site under the health center’s approved scope of project, neither
the patient nor any of the services at the facility for that patient are counted in the UDS.
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Counting Multiple Visits by Category of Service
Multiple visits may occur when a patient has more than one visit with the health center in a day (in-person and/or
virtual).
Count only one visit per patient per service category per provider per location in a single day, regardless of the
types or number of services provided or where they occur, as described in the table that follows.
Other considerations:
•
If multiple medical providers in a single category deliver multiple services to a patient on a single day at the
same service delivery site, count only one visit, even if third-party payers may recognize these as separate
billable services. This is typically credited to the provider performing the highest level of or most care,
although the health center needs to make this determination for itself.
•
Count two visits in a scenario in which services are provided to a patient on the same day by two different
providers of the same service category type who are located at two different service delivery sites.
•
o
This lets patients who are in challenging environments to receive services outside the health center from a
licensed or credentialed health center provider and receive services again on the same day at the health
center from a different licensed or credentialed provider.
o
This also lets patients seen at a health center service delivery site by one provider be seen on the same day
at the hospital by another health center provider.
A virtual visit may count as a separate visit when a patient has another visit on the same day, but only if the
providers are different and the assigned service delivery location of each provider is different.
Maximum Number of Visits per Patient per Day per Service Category at the Same Service Delivery Site
# of Visits
Service Category
1
Medical
1
Dental
1
Mental health
1
1 for each provider type
1
1 for each provider type
Substance use disorder
Other professional
Vision
Enabling
Provider Examples
physician, nurse practitioner, physician assistant, certified
nurse midwife, nurse
dentist, dental hygienist, dental therapist
psychiatrist, licensed clinical psychologist, licensed clinical
social worker, board-certified psychiatric nurse practitioner,
other licensed or unlicensed mental health providers
alcohol and SUD specialist, psychologist, social worker
nutritionist, podiatrist, speech therapist, acupuncturist
ophthalmologist, optometrist
case manager, health educator
PATIENT
Patients are people who have at least one countable visit during the calendar year. The term “patient” applies
to everyone who receives clinic (in-person) or virtual visits in any of the seven service categories, NOT just those
who receive medical services. When patients are included in the UDS Report, they are to be reported in
corresponding sections only once, as described below.
The Universal Report includes all patients who had at least one visit during the calendar year within the scope of
project supported by the health center grant or designation.
•
19
On the Patients by ZIP Code Table, on Tables 3A and 3B, and in each section of Table 4, report each patient
once and only once. This applies even if they received more than one service (e.g., medical, dental, enabling)
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or received services supported by more than one funding stream authority (i.e., section 330(g), section 330(h),
section 330(i)).
•
Report these patients and their visits on Tables 5 and 6A for each type of service (e.g., medical, dental,
enabling) received during the calendar year.
•
Also report these patients, as applicable, for each of the clinical quality measures (CQMs) on Tables 6B and
7.
For each Grant Report, patients reported are those who had at least one countable visit during the calendar year
within the scope of project activities supported by the specific section 330 funding stream authority, even if the
specific service is not paid for by the grant. The number of patients reported in any cell on the Universal Report
includes all patients reported in the same cell in the Grant Report. Therefore, no cell on the Grant Report may
show a greater number than the number in the same cell on the Universal Report.
Services and Individuals NOT Reported on the UDS Report
Some services DO NOT count as a visit for UDS reporting, even though they are critical to the overall provision
of care to an individual or a community.
Someone who receives only the services described in the table below is NOT a patient for purposes of UDS
reporting, and the activity is not counted as a UDS countable visit.
If an individual receives additional services that fully meet the countable visit definition (i.e., the services require
independent professional judgment from a health center provider and those services are documented), they should
be considered a patient of the health center.
The following situations are NOT countable as visits:
Health
screenings or
outreach services
Group visits
Tests and
other ancillary
services
Dispensing or
administering
medications
20
• Do not count screenings (e.g., COVID-19, blood pressure, diabetes) or outreach as countable
visits, including:
o Information sessions for prospective patients.
o Health presentations to community groups.
o Information presentations about available health services at the center.
o Services conducted at health fairs or schools.
o Immunization drives.
o Services provided to groups, such as dental varnishes or sealants provided at schools.
o Hypertension or diabetes testing.
o Similar public health efforts that frequently occur as part of community activities that involve
conducting outreach or group education.
• Do not count visits conducted in a group setting, except for behavioral health group visits.
o The most common non-behavioral health group visits are patient education or health
education classes (e.g., people with diabetes learning about nutrition).
• Do not count services required to perform such tests, such as drawing blood or collecting urine,
and other ancillary services, including:
o Laboratory tests (e.g., COVID-19, purified protein derivatives [PPDs], pregnancy, or
Hemoglobin A1c [HbA1c]).
o Measuring and imaging (e.g., blood pressure, height, weight, sonography, radiology,
mammography, retinography, or computerized axial tomography).
• Do not count dispensing medications, including dispensing from a pharmacy or administering
medications (e.g., buprenorphine, warfarin).
• Do not count giving any injection (e.g., immunizations, vaccines, COVID-19, flu, allergy shots, or
contraceptives), regardless of education provided at the same time.
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Health status
checks
Services under
the Women,
Infants, and
Children (WIC)
program
• Do not count providing narcotic agonists or antagonists or mixes of these, regardless of whether
the patient is assessed at the time of the dispensing and regardless of whether these medications
are dispensed regularly.
• Do not count follow-up tests or checks (e.g., patients returning for glycemic status tests or blood
pressure checks).
• Do not count wound care (which is follow-up to the original primary care visit).
• Do not count taking health histories.
• Do not count making referrals for or following up on external referrals.
• Do not count a person whose only contact with a health center is to receive services (including
nutrition) under a WIC program.
Note: Although the services reflected in the table do not qualify as UDS countable visits, data regarding these
services may be required in reporting for certain CQMs.
PROVIDER
A provider exercises independent professional judgment in the provision of services rendered to the patient,
assumes primary responsibility for assessing and/or treating the patient for the care provided at the visit, and
documents services in the patient’s health record.
•
Except for physicians and dentists, allocate personnel (as full-time equivalent [FTE]) by function on Table 5
among the major service categories based on time dedicated to each position.
•
Providers may be employees of the health center, contracted personnel, or volunteers.
•
Contracted providers who are paid for their time by the health center with grant funds or program income and
who are part of the scope of project, serve center patients, and document their services in the health center’s
records count as providers; report their FTE.
•
Contracted providers who are paid for specific visits or services with grant funds or program income and
report patient visits to the direct recipient of a HRSA’s BPHC or BHW grant or designation are providers, but
if such providers do not have a time basis for their services, do not report an FTE for them. In these situations,
the health center—the direct recipient of the HRSA’s BPHC or BHW grant or designation— must report
these providers’ activities (patients, visits, revenue).
•
Providers who volunteer to serve patients at the health center’s service delivery sites under the supervision of
the health center’s personnel and document their services and time in the health center’s records count as
providers; report their FTE.
•
DO NOT count visits by providers who see patients under a formal unpaid referral agreement or contract
with the health center, unless they are working at an approved health center service delivery site under the
supervision of the appropriate health center personnel and are credentialed by the health center. These
providers are generally providing services noted in Column III of the grant scope of project application Form
5A.
•
Report physicians according to the specialty in which they are board certified. If a physician has multiple
board certifications, report the physician under the specialty in which they are functioning. FTE and visits for
physicians with multiple board certifications should be allocated and reported according to the specialty they
are practicing.
•
Appendix A provides a listing of personnel. Only personnel designated as a “provider” can generate countable
visits for purposes of UDS reporting.
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•
Only one provider receives credit for a visit, even when two or more providers are present and participate in
the visit (see Counting Multiple Visits by Category of Service).
•
In cases where a preceptor (or attending physician) is following and supervising a licensed resident, only the
licensed resident or fellow receives credit for countable visits. (See Appendix B for further instruction on
counting interns and residents.)
•
When health center personnel are following a patient in the hospital, the primary health center personnel in
attendance during the visit is the provider who receives credit for the visit, even if other personnel are present.
•
Table 5 provides further clarifications to these definitions. See Instructions for Table 5: Staffing and
Utilization.
FAQ FOR THE INSTRUCTIONS FOR TABLES
1. What level of documentation is required for emergency, hospital, or respite services? Can we count the
visit if the record is incomplete?
A patient receiving documented emergency services counts even if some portions of the patient health record
are incomplete. Providers who see their established patients at a hospital or respite care facility and make a
note in the institutional file can satisfy this criterion by including a summary discharge or interim note
showing activities for each of the visit dates.
2. Do we credit a visit to the nurse assisting a physician?
No. For example, a nurse assisting a physician during a physical examination by taking vital signs, recording
a history, or drawing a blood sample does NOT receive credit as a separate visit. Visits that the nurse provides
independently, and that fully meet countable visit criteria, may be credited to the nurse. Countable medical
visits usually involve one of the “Evaluation and Management” billing codes (99202–99205 or 99211–99215)
or one of the health maintenance codes (99381–99387, 99391–99397).
3. Two different medical providers treated the patient at the health center on the same day. Can we count
both?
No. Only count one visit per service category when care is provided at the same location. For example, only
count one medical visit if an obstetrician/gynecologist (OB/GYN) provides prenatal care to a patient at the
health center and a nurse practitioner treats that same patient’s hypertension at the same location on the same
day. Other examples may include: a family physician and a pediatrician who both see a child or a dental
hygienist and a dentist who both see a patient on the same day.
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Instructions for Patients by ZIP Code Table
The Patients by ZIP Code Table collects data on patients’ geographic residence by ZIP code5 and by primary
medical insurance.
The text directly below indicates changes from 2024 calendar year reporting to 2025 calendar year reporting:
There are no key changes to this table.
This marks the conclusion of changes from 2024 calendar year reporting to 2025 calendar year reporting.
PATIENTS BY ZIP CODE
•
All health centers must report the number of patients served by ZIP code and primary medical insurance.
•
This information enables HRSA’s BPHC to better identify areas served by health centers, service area
overlaps, and possible areas of unmet need.
•
Patients may be mobile during the calendar year; report patients’ most recent ZIP code on file.
•
ZIP code information for each patient is to be updated each calendar year.
ZIP Code of Specific Groups
For health centers serving patients without residence information, such as individuals from transient groups,
follow the instructions below:
• Report the service location ZIP code as a proxy when a residence ZIP code location is
unavailable. If the patient is staying at a shelter or otherwise has an address, use the ZIP code of
that location.
Homeless
population
• If the patient receives services in a mobile health center van and has no other ZIP code, report the
ZIP code of the van’s location on the day of that visit.
• If the patient is living in permanent supportive housing or doubled up, report that location as the
ZIP code.
• Although it is appropriate from a clinical and service delivery perspective to collect the address of
a contact person to facilitate communication with the patient; DO NOT use the contact person’s
address as the patient’s address.
Patients who are
migratory and
seasonal
agricultural
workers
Patients who are
foreign nationals
• Report the ZIP code of where the patient lived when they received care from the health center.
Migratory agricultural workers (as opposed to seasonal agricultural workers) may have both a
temporary address, where they live when working, and a permanent or “downstream” address.
• Report the ZIP code for the location (fixed service delivery site or mobile camp) where patients
received services, for those whose ZIP code is unavailable (e.g., living in cars or on the land).
• Report the current ZIP codes for people from other countries who reside in the United States
either permanently or temporarily.
• Report “Other ZIP Code” in cases where patients have a permanent residence outside the country,
if they have no temporary address in the United States.
5
The geographic residence of patients served during the calendar year is generally the same as the health center service area and should generally align with
the ZIP codes recorded in the health center scope of project.
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Unknown ZIP Code
In rare instances, for patients whose residence is not known or for whom a proxy ZIP code is not available, report
residence in the “Unknown” category.
Ten or Fewer Patients in ZIP Code
To ease the burden of reporting, combine and report patients from ZIP codes that have 10 or fewer patients in the
“Other ZIP Codes” category.
INSTRUCTIONS FOR PATIENTS BY MEDICAL INSURANCE
•
Report the patient’s primary medical insurance covering medical care, if any, as of their last visit during
the calendar year.
•
Report primary medical insurance for all patients, regardless of the services they receive. This applies to
patients who did not receive medical care, such as dental-only or behavioral health-only patients, as well as
patients whose medical insurance did not cover the service.
•
Report patients’ ZIP code by their primary medical insurance.
•
DO NOT report children as Uninsured unless they are receiving minor consent services or their family is
uninsured.
•
DO NOT report patients as Uninsured simply because they are receiving a service that is not covered by
health insurance.
Insurance Categories
Primary medical insurance is the insurance plan that the health center would typically bill first for medical
services, even if that insurance pays for none or only a portion of the visit. Specific rules guide reporting:
•
The categories for this table are slightly different from those on Table 4; they combine Medicaid, Children’s
Health Insurance Program (CHIP), and Other Public into one category.
•
Report patients who have both Medicare and Medicaid (dually eligible) as Medicare patients, because
Medicare is billed before Medicaid. The exception to the Medicare-first rule is the Medicare-enrolled patient
who is still working and insured by both an employer-based plan and Medicare. In this case, the primary
health insurance is the employer-based plan, which is billed first.
•
Report Medicare administered by a private insurance company as Medicare.
•
Report Medicaid and CHIP patients enrolled in a managed care plan administered by a private insurance
company as Medicaid/CHIP/Other Public.
•
Report the patient by their medical insurance, even if for some reason the health center does not bill the
specified insurance.
•
Report only third-party insurance that patients carry. Section 330 grant awards used to serve special medically
underserved populations (e.g., MSAW, HP, RPH) are NOT a form of medical insurance.
•
Report justice-involved patients as Uninsured (whether they were seen in the correctional facility or at the
health center), unless Medicaid or other insurance covers them, and at the ZIP code of the carceral facility.
•
In instances where patients reside in residential drug programs, college dorms, or military barracks, report the
patient as living at the ZIP code of the residential program, dorm, or barrack and by their primary medical
insurance, NOT as Uninsured.
24
2025 UDS MANUAL | Instructions for ZIP Codes
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•
Report patients whose care is paid for by state or local government indigent care programs as Uninsured.
•
Report patients who received insurance through the Health Insurance Marketplace as Private.
FAQ FOR PATIENTS BY ZIP CODE TABLE
1. Do we need to collect information and report on the ZIP code of all our patients?
Yes. Although health centers report residence by ZIP code for all patients, some centers may draw patients
from multiple ZIP codes outside of their normal service area. To ease the burden of reporting, combine ZIP
codes with 10 or fewer patients in the “Other” category.
2. Do we need to collect information and report on the primary medical insurance of all our patients?
Yes. Although the ZIP code of a patient may be Unknown, medical insurance information must be obtained
for every individual counted as a patient.
3. If a patient did not receive medical care, do we still need their medical insurance information? What
about dental patients?
Yes. This information is about patients’ primary medical insurance resources, not billing. Obtain medical
insurance information for all patients, even dental-only patients. For example, if a patient received only
mental health services, still determine whether they have primary medical insurance and report it.
4. How do we report patients by insurance when we DO NOT bill that form of insurance?
All patients must be asked for their primary medical insurance, generally through the patient registration
process, although it may be explained to them that this is required for planning purposes and that their
insurance will not be billed. Report the patient by their primary medical insurance, even in those instances
that the health center does not or cannot bill to that insurance. For example, report patients enrolled in
managed care Medicaid but assigned to another primary care provider as Medicaid, and report patients with
private insurance for which the health center’s providers have not been credentialed as Private.
5. How do we report patients by insurance who have their care subsidized by an indigent care program?
Report patients as Uninsured when their care is subsidized by a state or local government indigent care
program. Examples include New Jersey’s Uncompensated Care Program, New York’s Public Goods Pool
Funding, and Colorado’s Indigent Care Program.
6. We see children at local schools. Do we include the patients seen in the report?
Report children served in school-based service sites only if they have completed clinic intake forms that show
insurance status and family/household income and the patient had a countable visit. If the patient had a
countable visit, report the patient by ZIP code of residence by primary medical insurance.
7. Does the number of patients reported by ZIP code need to equal the total number of unduplicated
patients reported on Tables 3A, 3B, and 4?
Yes. Several tables and sections must match:
•
25
The total number of patients reported by ZIP code (including Unknown and Other) on the Patients by ZIP
Code Table must equal the number of total unduplicated patients reported on Table 3A, the race and
ethnicity section totals of Table 3B, and the income and insurance section totals of Table 4.
2025 UDS MANUAL | Instructions for ZIP Codes
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•
26
The insurance totals reported on the Patients by ZIP Code Table must equal insurance reported on Table
4. Specifically:
o
The total for Patients by ZIP Code Table Column B (Uninsured) must equal Table 4, Line 7, Columns
A + B.
o
The total for Patients by ZIP Code Table Column C (Medicaid/CHIP/Other Public) must equal the
sum of Table 4, Line 8, Columns A + B and Line 10, Columns A + B.
o
The total for Patients by ZIP Code Table Column D (Medicare) must equal Table 4, Line 9, Columns
A + B.
o
The total for Patients by ZIP Code Table Column E (Private) must equal Table 4, Line 11, Columns
A + B.
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PATIENTS BY ZIP CODE TABLE
Calendar Year: January 1, 2025, through December 31, 2025
None/
Uninsured
(b)
ZIP Code
(a)
Medicaid/
CHIP/Other Public
(c)
Medicare
(d)
Private
(e)
Total
Patients (f)
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[Blank for demonstration]
Other ZIP Codes
Unknown Residence
Total
Note: The actual output from the EHBs will display ZIP codes entered by the health center in Column A.
Patients by ZIP Code Table Cross-Table Considerations:
•
Patients by ZIP Code Table and Tables 3A, 3B, and 4 describe the same patients and the totals must be equal.
•
The number of patients by insurance source reported on the Patients by ZIP Code Table must be consistent
with the number of patients by insurance category reported on Table 4.
27
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Instructions for Tables 3A and 3B
Tables 3A and 3B collect demographic data (age, sex, race, ethnicity, and language) for patients who accessed
services during the calendar year. This information must be collected from patients initially as part of the patient
registration or intake process and updated or confirmed annually thereafter.
Table 3A: Patients by Age and by Sex – Instructions
Table 3A provides an unduplicated count of each patient’s age and sex.
The text directly below indicates changes from 2024 calendar year reporting to 2025 calendar year reporting:
There are no key changes to this table.
This marks the conclusion of changes from 2024 calendar year reporting to 2025 calendar year reporting.
•
Report the number of patients by appropriate categories for age and sex.
•
Use the individual’s age on December 31, 2025.
•
Report the date of birth and sex6 listed on the birth certificate for all patients. There is no “Unknown” or
“Other” category on this table.
Note: On the non-prenatal portions of Tables 6B and 7, age is defined differently by measure. Thus, the numbers
on Table 3A may not be the same as those on Tables 6B and 7 (though they will usually be similar).
6
“Sex” refers to an individual’s immutable biological classification as either male or female.
28
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Table 3B: Demographic Characteristics – Instructions
Table 3B provides an unduplicated count of patients by demographic characteristics.
The text directly below indicates changes from 2024 calendar year reporting to 2025 calendar year reporting:
A key change has been made to Table 3B, as outlined below:
•
The previous Table 3B, Lines 13-26, are no longer to be reported.
This marks the conclusion of changes from 2024 calendar year reporting to 2025 calendar year reporting.
Report the number of patients by their self-identified race, ethnicity, and language preference.
PATIENTS BY HISPANIC, LATINO/A, OR SPANISH ETHNICITY AND RACE (LINES 1–8)
Table 3B displays the race and ethnicity of the patient population in a matrix format. This allows for reporting on
the racial and ethnic identification of all patients.
Hispanic, Latino/a, or Spanish Ethnicity
Table 3B collects information on whether or not patients consider themselves to be of Hispanic, Latino/a, or
Spanish ethnicity, regardless of their race.
29
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Columns A1–A5
–
(Hispanic, Latino/a, or Spanish
Origin)
• Report the number of patients of
Mexican, including Mexican
American and Chicano/a (Column
A1), Puerto Rican (Column A2),
Cuban (Column A3), another
Spanish culture or origin (Column
A4), or Hispanic, Latino/a, or
Spanish origin combined (Column
A5), broken out by their racial
identification. Include in this count
Hispanic, Latino/a, or Spanish
origin patients born in the United
States or another country.
Column B
(Not Hispanic, Latino/a, or Spanish
Origin)
• Report the number of patients who
indicate that they are NOT of
Hispanic, Latino/a, or Spanish
origin.
• If a patient self-reported a race but
has not made a selection for the
Hispanic/Not Hispanic, Latino/a, or
Spanish origin question, presume
that the patient is NOT of Hispanic,
Latino/a, or Spanish origin.
• Report patients who are of
Hispanic, Latino/a, or Spanish
origin but for whom granularity of
ethnicity is not known, as well as
patients who select more than one
ethnicity, in Column A5 (e.g.,
Mexican and Puerto Rican).
• Report patients who self-report as
being of Hispanic, Latino/a, or
Spanish ethnicity but DO NOT
separately select a race on Line 7,
as “Unreported/Chose not to
disclose race.” Health centers
should not default these patients to
any other category.
• DO NOT include patients from
Portugal, Brazil, or Haiti whose
ethnicity is not otherwise tied to the
Spanish language, unless they selfidentify as being of Hispanic,
Latino/a, or Spanish origin.
30
2025 UDS MANUAL | Instructions for Tables 3A and 3B
Column C
(Unreported/Chose Not to Disclose
Ethnicity)
• Report on Line 7 only those
patients who left the entire race and
Hispanic, Latino/a, or Spanish
ethnicity part of the intake form
blank or those who indicated that
they choose not to disclose these
data. Only one cell is available in
this column.
Note: Column C is grayed out on
all race lines except for the
“Unreported/Chose not to disclose
race” line.
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Race
All patients must be classified in one of the racial categories.
•
•
Report patients in one of 16 race categories:
o
Line 1, Asian, as Asian Indian (Line 1a), Chinese (Line 1b), Filipino (Line 1c), Japanese (Line 1d),
Korean (Line 1e), Vietnamese (Line 1f), or Other Asian (Line 1g)
o
Line 2, Native Hawaiian/Other Pacific Islander, as Native Hawaiian (Line 2a), Other Pacific Islander
(Line 2b), Guamanian or Chamorro (Line 2c), or Samoan (Line 2d)
o
Line 3, Black or African American
o
Line 4, American Indian/Alaska Native
o
Line 5, White
o
Line 6, More than one race
o
Line 7, Unreported/Chose not to disclose race
Patients categorized as “Asian/Asian American/Pacific Islander” in other systems are reported on the UDS in
one of five distinct categories:
o
Line 1, Asian: Patients having ancestry in any of the original peoples of Asia, Southeast Asia, or the
Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan,
the Philippine Islands, Indonesia, Thailand, or Vietnam.
▪
Include in the Other Asian category patients who are Asian, but for whom the granularity of their race
is not known, as well as patients who select more than one of the Asian subcategories listed (e.g.,
Chinese and Filipino).
o
Line 2a, Native Hawaiian: Patients having ancestry in any of the original peoples of Hawai’i.
o
Line 2b, Other Pacific Islander: Patients having ancestry in any of the original peoples of Tonga, Palau,
Chuuk, Yap, Kosrae, Ebeye, Pohnpei, or other Pacific Islands in Melanesia or Oceana.
▪
Include in the Other Pacific Islander category patients who are of other Pacific islands not reported on
Lines 2a, 2c, or 2d, as well as patients who are of other Pacific islands for whom the granularity of
their race is not known.
o
Line 2c, Guamanian or Chamorro: Patients having ancestry in any of the original peoples of the
Northern Mariana Islands, Guam, Saipan, Tinian, Rota, or other Mariana Islands in Micronesia.
o
Line 2d, Samoan: Patients having ancestry in any of the original peoples of the Samoan Islands, Savai’i,
Manono, Upolu, Tutuila, Pola Island, Aunu’u, or other Samoan Islands in American Samoa or Polynesia.
▪
Include in the Other Pacific Islander category patients who are Other Pacific Islander but for whom
the granularity of their race is not known, as well as patients who select more than one of the Other
Pacific Islander subcategories (e.g., Guamanian and Samoan).
•
Report patients who trace their ancestry to any of the original peoples of North, South, and Central America
and who maintain tribal affiliation or community attachment on Line 4, American Indian/Alaska Native.
•
Report patients who trace their ancestry to any of the original peoples of Europe, the Middle East, or North
Africa on Line 5, White.
•
Line 6, More than one race: Use this line only if your system captures multiple races and the patient has
chosen two or more races (but not a race and an ethnicity). This is usually done with an intake form that lists
31
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the races and tells the patient to “check one or more” or “check all that apply.” “More than one race” must
NOT appear as a selection option on your intake form.
o
o
Report patients who select multiple races within the Asian or Native Hawaiian/Other Pacific Islander race
categories on the “other” race line for that category. DO NOT report these patients on Line 6, More than
one race.
▪
Report patients who select multiple Asian races (Lines 1a–1f) as Other Asian (Line 1g).
▪
Report patients who select multiple Native Hawaiian/Other Pacific Islander races (Lines 2a–2c) as
Other Pacific Islander (Line 2d).
DO NOT use “More than one race” for Hispanic, Latino/a, or Spanish people who DO NOT select a race.
Report these patients on Line 7 (Unreported/Chose not to disclose), as noted above.
•
Report patients who did not provide their race, including when information was sought but not found or asked
but unknown, on Line 7, Unreported/Chose not to disclose race.
•
Report patients who self-report their race but DO NOT indicate if they are Hispanic, Latino/a, or Spanish
origin in Column B as not of Hispanic, Latino/a, or Spanish origin on the appropriate race line.
PATIENTS BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH (LINE 12)
This section of Table 3B identifies the patients who may have linguistic barriers to care.
•
Report on Line 12 the number of patients who are best served in a language other than English, including
those who are best served in sign language. This line does not discern between written and spoken preference;
it could be either or both.
•
Include those patients who were served in a second language by a bilingual provider, a third-party interpreter,
and those who may have brought their own interpreter.
•
Include patients who are best served in a language other than English, even when the health center is in an
area where a language other than English is the dominant language, such as Puerto Rico or the Pacific Islands.
FAQ FOR TABLES 3A AND 3B
1. Our health center collects different race and ethnicity data than required by the UDS. Why are the
data collected at this level?
The UDS classifications are consistent with the guidance issued by the Office of Management and Budget
(OMB) prior to 2025 titled “U.S. Department of Health and Human Services Implementation Guidance on
Data Collection Standards for Race, Ethnicity, Sex, Primary Language, and Disability Status.” These
standards govern the categories used to collect and present federal data on race and ethnicity. Prior to 2025
and before implementation of OMB’s Statistical Policy Directive No. 15 (SPD 15), OMB required a
minimum of five categories (White, Black or African American, American Indian or Alaska Native, Asian,
and Native Hawaiian or Other Pacific Islander) for race. While SPD 15 requirements are effective as of
March 28, 2024, U.S. Department of Health and Human Services (HHS) agencies have until March 28, 2029,
to come into full compliance. HRSA is currently working with health centers and health information
technology vendors supporting health centers to meet the additional reporting requirements. For now, HRSA
remains aligned with the previous requirements. HHS data standards that were in place prior to 2025 and used
for the reporting of race and ethnicity for Table 3B are based on the disaggregation of the OMB standard.
32
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2. Do we have to report the race and ethnicity of all our patients?
Yes. Health centers whose data systems DO NOT support such reporting must enhance their systems to
permit the required level of reporting, rather than using the “Unreported/Chose not to disclose” categories. If
a patient self-identifies as of Hispanic, Latino/a, or Spanish origin with no distinction within the sub
categories listed (Mexican, Mexican American, Chicano/a, Puerto Rican, Cuban, another Spanish origin),
report the patient in Column A5. Also report patients who report more than one ethnicity (e.g., Hispanic and
other Spanish origin) in Column A5.
3. How are patients of Hispanic, Latino/a, or Spanish ethnicity reported?
Race and ethnicity data appear in a matrix on Table 3B. Patients who in other systems might be reported as
Hispanic or Latino/a independent of race are reported in Column A (in one of the detail columns, A1–A4) of
Table 3B of the UDS as of Hispanic, Latino/a, or Spanish origin and reported on Lines 1–7 based on their
race. If Hispanic, Latino/a, or Spanish ethnicity is the only identification recorded in the center’s patient files,
report these patients in Column A on Line 7 as having an “unreported” racial identification, and update your
data system to permit the collection of both race and ethnicity for future reporting.
4. Can we have a choice on our registration form of “more than one race”?
No. To count patients as being of “more than one race,” they must have the option of checking two or more
boxes under race and must have indeed checked more than one. Do not include “more than one race” as an
option on registration forms.
5. How are patients who receive different types of services or use more than one of our health center’s
service delivery sites reported? For example, how do we report a patient who receives both medical and
dental services or a patient who receives primary care from one service delivery site but gets prenatal
care at another?
The Patients by ZIP Code Table and Tables 3A, 3B, and 4 each provide an unduplicated patient count. Count
each individual who has at least one visit reported on Table 5 only once on the Patients by ZIP Code Table
and Tables 3A, 3B, and 4, regardless of the type or number of services they receive or where they receive
them. We define visits in detail in the Instructions for Tables that Report Visits, Patients, and Providers
section. Note the following:
DO NOT count individuals who:
•
receive Women, Infants, and Children (WIC) services and no other services at the health center as
patients on Table 3A or 3B (or anywhere in the UDS).
•
only receive imaging or lab services or whose only service was an immunization or screening test as
patients on Table 3A or 3B (or anywhere in the UDS).
•
only receive health status checks and health screenings as patients on Table 3A or 3B (or anywhere in the
UDS).
6. Do we exclude from the UDS Report a patient who died during the calendar year?
No. If a patient was seen before their death during the calendar year, include the patient and their visits in all
applicable areas of the UDS Report, including their demographics, services, and clinical care details.
33
2025 UDS MANUAL | Instructions for Tables 3A and 3B
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7. Should the totals on Tables 3A and 3B be equal to UDS totals reported on other tables or sections?
Yes.
The sum of Table 3A, Line 39, Columns A and B (total patients by age and by sex) must equal:
•
Patients by ZIP Code Table total;
•
Table 3B, Line 8, Column D (total patients by Hispanic, Latino/a, or Spanish ethnicity and race);
•
Table 4, Line 6 (total patients by income); and
•
Table 4, Line 12, Columns A and B (total patients by insurance status).
The sum of Table 3A, Lines 1–18, Columns A and B (total patients age 0–17 years) must equal:
•
Table 4, Line 12, Column A (total patients age 0–17 years).
The sum of Table 3A, Lines 19–38, Columns A and B (total patients age 18 and older) must equal:
•
Table 4, Line 12, Column B (total patients age 18 and older).
8. I have multiple, separate data systems. How do I include their data on these tables?
It is the health center’s responsibility to make sure there is no duplication of data. Count patients only once,
regardless of the number of different types of services they receive. This may require the downloading and
merging of data from each system to eliminate duplicates or checking them manually. This can be a timeconsuming and potentially expensive process and should start as soon as the year ends to ensure sufficient
time for completion before the submission due date.
34
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TABLE 3A: PATIENTS BY AGE AND BY SEX
Calendar Year: January 1, 2025, through December 31, 2025
Line
Age Groups
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
Under age 1
Age 1
Age 2
Age 3
Age 4
Age 5
Age 6
Age 7
Age 8
Age 9
Age 10
Age 11
Age 12
Age 13
Age 14
Age 15
Age 16
Age 17
Age 18
Age 19
Age 20
Age 21
Age 22
Age 23
Age 24
Ages 25–29
Ages 30–34
Ages 35–39
Ages 40–44
Ages 45–49
Ages 50–54
Ages 55–59
Ages 60–64
Ages 65–69
Ages 70–74
Ages 75–79
Ages 80–84
Age 85 and over
Male Patients
(a)
Total Patients
(Sum of Lines 1–38)
Female Patients
(b)
Table 3A Cross-Table Considerations:
•
Table 3A, Line 39 = Table 3B, Line 8, Column D = total patients on the Patients by ZIP Code Table = Table
4, Lines 6 and 12.
•
If you submit Grant Reports, the total number of patients reported on each grant table must be less than or
equal to the corresponding number on the Universal Report for each cell.
35
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TABLE 3B: DEMOGRAPHIC CHARACTERISTICS
Calendar Year: January 1, 2025, through December 31, 2025
blank
Patients by Race and
Hispanic, Latino/a, or
Spanish Ethnicity
Line
Patients by Race
1a
1b
1c
1d
1e
1f
1g
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian
Total Asian (Sum Lines
1a+1b+1c+1d+1e+1f+1g)
Native Hawaiian
Other Pacific Islander
Guamanian or Chamorro
Samoan
Total Native
Hawaiian/Other Pacific
Islander
(Sum Lines 2a+2b+2c+2d)
Black or African American
American Indian/Alaska
Native
White
More than one race
Unreported/Chose not to
disclose race
Total Patients
(Sum of Lines 1 + 2 + 3 to
7)
1
2a
2b
2c
2d
2
3
4
5
6
7
8
36
blank
Yes,
Mexican,
Mexican
American,
Chicano/a
(a1)
blank
blank
blank
Unreported
/ Chose Not
to Disclose
Ethnicity
(c)
Total
(d)
(Sum
Columns
a+b+c)
Yes,
Puerto
Rican
(a2)
Yes,
Cuban
(a3)
Yes,
Another
Hispanic,
Latino/a, or
Spanish
Origin
(a4)
Yes,
Hispanic,
Latino/a,
Spanish
Origin,
Combined
(a5)
Total Hispanic,
Latino/a, or
Spanish Origin
(a) (Sum
Columns a1 +
a2 + a3 + a4 +
a5)
Not
Hispanic,
Latino/a,
or
Spanish
Origin
(b)
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Line
Patients Best Served in a Language Other than English
12
Patients Best Served in a Language Other than English
Number
(a)
Table 3B Cross-Table Considerations:
•
•
•
37
Table 3B, Line 8 = Table 3A, Line 39 = Patients by ZIP Code Table = Table 4, Lines 6 and 12.
Tables 3B and 7 both report patients by race and Hispanic, Latino/a, or Spanish ethnicity. The data sources for
identifying race and ethnicity for the two tables should be the same, and the number of patients reported on
Table 7 by race and ethnicity cannot exceed the number of patients in the same category on Table 3B.
If you submit Grant Reports, the total number of patients reported on each grant table must be less than or
equal to the corresponding number on the Universal Report for each cell.
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Instructions for Table 4: Selected Patient Characteristics
Table 4 collects descriptive data on selected characteristics of health center patients.
The text directly below indicates changes from 2024 calendar year reporting to 2025 calendar year reporting:
There are no key changes to this table.
This marks the conclusion of changes from 2024 calendar year reporting to 2025 calendar year reporting.
INCOME AS A PERCENTAGE OF POVERTY GUIDELINE, LINES 1–6
The report should include the most current income data for all patients (not only from patients eligible for a
sliding fee discount), which must have been collected at or within 12 months of the last calendar year visit.
Determine a patient’s income relative to the 2025 federal poverty guidelines (FPG).
•
Report patients by income, as defined by the health center’s board policy consistent with the Health Center
Program Compliance Manual. Children, except for emancipated minors or those presenting for minor consent
services, should be classified using their parents’ or guardians’ income.
•
Report patients whose information was not collected at or within 12 months of their last visit in the calendar
year on Line 5 as “Unknown.”
•
Self-declaration of income from patients is acceptable as long as that is consistent with the health center’s
board-approved policies and procedures for collecting these data. This option is particularly important for
those patients whose wages are paid in cash and who have no means of documenting their income. If income
information consistent with the health center’s board policy is lacking, report the patient as having
“Unknown” income.
•
DO NOT allocate patients with “Unknown” income to the other income groups.
•
DO NOT classify a patient who is in the homeless population, is a migratory or seasonal agricultural worker,
or is on Medicaid as having income below the FPG based on these factors alone.
PRIMARY THIRD-PARTY MEDICAL INSURANCE, LINES 7–12
This portion of the table provides data on patients classified by their age and primary source of insurance for
medical care. Health centers are required to collect medical insurance information each calendar year from all
patients to maximize third-party payments. Note that there is NO “Unknown” insurance classification on this
table. DO NOT report other forms of insurance, such as dental, mental health, or vision coverage. Also note that
states often rename federal insurance programs, such as the Children’s Health Insurance Program (CHIP) and
Medicaid.
•
Report the primary medical insurance patients had at the time of their last visit, regardless of whether that
insurance was billed or paid for any or all of the visit services.
Note: If a patient’s medical insurance is NOT known but they have dental insurance through Medicaid, a
private insurer, or another public insurance source at the time of their last visit, you may assume the patient
has the same source of medical insurance as they have for dental. Although, if they DO NOT have dental
insurance at the time of their last visit, you may NOT assume they are Uninsured for medical care. In that
case, you must determine whether they have medical insurance.
•
38
Patient primary medical insurance is classified into seven types, as shown on the following pages.
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•
In rare instances, a patient may have insurance that the health center cannot or does not bill. Even in these
instances, report the patient as being insured and report the type of insurance.
•
Patients are divided into two age groups: 0–17 (Column A) and 18 and older (Column B) based on their age
on December 31, 2025 (consistent with ages reported on Table 3A).
•
DO NOT report public programs that reimburse for selected services, such as the Early and Periodic
Screening, Diagnosis, and Treatment (EPSDT) program; Breast and Cervical Cancer Early Detection Program
(BCCEDP); or Title X, as a patient’s primary medical insurance.
Note: Report the revenue from public programs that reimburse for selected services as Other Public payers on
Table 9D.
None/Uninsured (Line 7)
Report patients who did NOT have medical insurance at the time of their last visit on Line 7. This may include
patients who were insured earlier in the year and patients whose visit was paid for by a third-party source that was
not insurance, such as EPSDT, BCCEDP, Title X, or some state or local safety net or indigent care programs.
Some considerations:
•
Report a minor receiving services with parental consent under the family’s insurance.
•
Report children seen in a school-based service site under their parent’s health insurance. This information
must be obtained if they are to be included in the UDS Report. Report emancipated minors or patients seeking
minor consent services permitted in the state, such as voluntary family planning or mental health services, as
Uninsured if they DO NOT have access to the parent’s information.
•
Presume a patient with Medicaid, Private, or Other Public dental insurance to have the same kind of medical
insurance. If a dental patient does not have dental insurance, you may NOT assume that they are uninsured
for medical care. Instead, obtain this information from the patient.
•
Patients served in correctional facilities may be classified as Uninsured unless there is documentation of
insurance, such as Medicaid or Medicare, in which case report them on that insurance line.
•
Obtain the coverage information of patients in facilities (other than correctional), such as residential drug
programs, college dorms, and military barracks. DO NOT assume them to be uninsured.
•
DO NOT report patients as Uninsured if they have medical insurance that did not pay for their visit. Report
them with the primary medical insurance they have.
Medicaid (Line 8a)
Report patients covered by state-run programs operating under the guidelines of Titles XIX and XXI (as
appropriate) of the Social Security Act.
•
Include Medicaid programs known by state-specific names (e.g., California’s “Medi-Cal” program).
•
Include patients covered by “state-only” programs covering individuals who are ineligible for federal
matching funds (e.g., pregnant women) and paid through Medicaid, if they cannot otherwise be identified as
having another insurance.
•
Report patients enrolled in both Medicaid and Medicare on Lines 9 (Medicare) and 9a (Dually Eligible), but
not on Line 8a (Medicaid).
•
Report patients who are enrolled in Medicaid but receive services through a managed care plan administered
by a private insurer that contracts with the state Medicaid agency on Line 8a (Medicaid), not as privately
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insured (Line 11). This also applies in states that have a Medicaid waiver permitting Medicaid funds to be
used to purchase private insurance for services.
CHIP Medicaid (Line 8b)
Report patients covered by the CHIP Reauthorization Act and provided through the state’s Medicaid program.
•
In states that use Medicaid to handle the CHIP program, it is sometimes difficult or impossible to distinguish
between “Medicaid” and “CHIP Medicaid.” In other states, the distinction is readily apparent (e.g., they have
different cards). Even where it is not obvious, CHIP patients might still be identifiable from a “plan” code or
some other embedded code in the membership number. This may also vary from county to county within a
state. Obtain information on coding practice from the state and/or county.
•
If there is no way to distinguish between Medicaid and CHIP administered through Medicaid, classify all
covered patients as Medicaid (Line 8a).
Medicare (Line 9)
Report patients with the following primary medical insurance on Line 9, Medicare, only. DO NOT include them
on Line 9a (Dually Eligible), or on another insurance line:
•
Patients covered by the federal insurance program for the aged, blind, and disabled (Title XVIII of the Social
Security Act).
•
Patients who have Medicare and a private (“Medigap”) insurance.
•
Patients enrolled in “Medicare Advantage” products, even though their services were covered by a private
insurance company.
Report patients who have Medicare and Medicaid (“dually eligible”) on Line 9. In addition, report them on Line
9a (Dually Eligible).
Report Medicare-enrolled patients who are still working and are insured by both an employer-based plan and
Medicare as Private Insurance on Line 11, because the employer-based insurance plan is billed first. DO NOT
include them as Medicare on Line 9 or Dually Eligible on Line 9a.
Dually Eligible (Medicare and Medicaid) (Line 9a)
Report patients with both Medicare and Medicaid insurance on Line 9a and include them on Line 9. Line 9a
(Dually Eligible) is a subset of Line 9 (Medicare).
•
Report patients who are dually eligible and enrolled in both Medicare and Medicaid.
•
Report patients who are enrolled in Dual Eligible Special Needs Plan.
•
DO NOT include Medicare gap “Medigap” (supplemental insurance plan) enrollees on Line 9a. Report
patients who buy Medicare gap insurance as Medicare patients, on Line 9.
Other Public Insurance (Non-CHIP) (Line 10a)
Report state and/or local government programs that provide a broad set of benefits for eligible individuals.
Include any public-paid or subsidized private insurance not reported elsewhere on Table 4.
•
40
Report Medicaid expansion programs (such as state premium assistance programs) using Medicaid funds to
help patients purchase their insurance through exchanges as Medicaid (Line 8a) if it is possible to identify
them. Otherwise, report them as Private Insurance (Line 11).
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•
DO NOT report any CHIP, Medicaid, or Medicare patients on Line 10a.
•
DO NOT report uninsured individuals whose visit may be covered by a public source with limited benefits,
such as Title X, EPSDT, BCCEDP, or AIDS Drug Assistance Program providing pharmaceutical coverage
for patients with human immunodeficiency virus (HIV).
Note: Public programs that reimburse for selected services are, however, considered Other Public payers on
Table 9D.
•
DO NOT include patients covered by workers’ compensation (which is liability insurance for the employer—
not health insurance for the patient).
•
DO NOT include patients who have insurance through federal or state insurance exchanges, regardless of the
extent to which their premium cost is subsidized (in whole or in part). Report them as Private Insurance (Line
11).
Other Public Insurance CHIP (Line 10b)
Report patients on the Other Public Insurance CHIP line in states where CHIP is contracted through a private
third-party payer.
•
Report CHIP programs that are run through the private sector, often administered through health maintenance
organizations (HMOs). Coverage may appear to be a private insurance plan (such as Blue Cross/Blue Shield)
but is funded through CHIP and is to be counted on Line 10b.
•
Report CHIP patients who are on plans administered by Medicaid coordinated care organizations (CCOs).
•
DO NOT report CHIP as Private Insurance.
Private Insurance (Line 11)
Report patients with health insurance provided by private (commercial) and not-for-profit companies.
•
Individuals may obtain insurance through employers or on their own.
•
Include patients who purchase insurance through the federal or state exchanges.
•
In states using Medicaid expansion to support the purchase of insurance through exchanges, report patients
covered under these plans on Line 8a (Medicaid). Report patients who are not identifiable as Medicaid
patients on Line 11 (Private Insurance).
•
Private insurance includes insurance purchased for public employees or retirees, such as Tricare, Trigon, or
the Federal Employees Benefits Program.
•
DO NOT report patients enrolled in “Medicare Advantage” as Private on Line 11. Report them as having
Medicare on Line 9.
MANAGED CARE UTILIZATION, LINES 13A–13C
This part of Table 4 provides data on managed care enrollment during the calendar year and specifically reports
on patient member months in health center contracted comprehensive medical managed care plans. The
interpretation of what is managed care is evolving to reflect current practices, which is likely to result in some
changes in reporting.
•
41
If patients are seen by the health center for services but are enrolled in (assigned and attributed to) a managed
care plan elsewhere, DO NOT include them as part of the health center’s managed care reporting.
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•
If the health center is responsible for the patient’s medical care (meaning that the patient is attributed to the
health center), even if the patient goes elsewhere for some of their care, report the number of months the
member was enrolled in a medical managed care plan on Lines 13a–13c. Report by managed care insurer and
plan type. Include patients who are enrolled and assigned to a managed care plan with the health center even
if they are not seen by the health center during the year.
•
DO NOT report in this section enrollees in primary care case management (PCCM) programs, the Centers for
Medicare & Medicaid Services (CMS) patient-centered medical home (PCMH) demonstration grants, or other
third-party plans that pay a monthly fee (often as low as $5 to $10 per member per month) to manage patient
care, unless they are also enrolled in a comprehensive medical managed care plan.
•
DO NOT include managed care enrollees whose capitation or enrollment is limited to behavioral health or
dental services only. (However, an enrollee who has medical and dental is counted.)
Note: The determination of managed care reporting in the UDS is that the health center has a contractual
agreement with a managed care organization or managed care plan, through which the health center is assigned
patients and manages the comprehensive care of those patients, assuming some risk in the process.
For example, the health center is measured on certain preventive care or quality indicators for assigned patients,
where there is some risk, either upside (e.g., incentives, shared savings, additional financial gains) or upside and
downside (e.g., potential financial gains or losses).
Member Months
A member month is defined as one individual enrolled in a managed care plan for one month. For example, an
individual who is a member of a plan for a full year generates 12 member months; a family of five enrolled for 6
months generates 30 member months (5 individuals × 6 months = 30 member months).
Member month information is most often obtained from monthly enrollment lists generally supplied by managed
care companies to their providers. Health centers should always save the information contained within these
documents. In the event they have not been saved, health centers should request duplicates early to permit timely
filing of the UDS Report.
Note: It is possible for an individual to be enrolled in a managed care plan, assigned to a health center, and yet not
seen during the calendar year. The member months for such individuals are still to be reported in this section.
This is the only place on the UDS tables that may report an individual who is not being counted as a
patient.
Capitated Member Months (Line 13a)
Report the total capitated managed care member months by source of payment. This is derived by adding the total
enrollment reported from each capitated plan for each month.
•
A patient is in a capitated plan if the contract between the health center and the HMO, accountable care
organization (ACO), or other similar plan stipulates that, for a flat payment per month, the health center will
provide the patient all the services on a negotiated list. (Oregon plans should include enrollees in CCOs on
this line.)
•
This usually includes, at a minimum, all medical office visits.
•
Payments are received (and reported on Table 9D) regardless of whether any service is rendered to the patient
in that month. The capitated member months reported on Line 13a relate to the net capitated revenue reported
on Table 9D, Lines 2a, 5a, 8a, and/or 11a.
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Fee-for-Service Member Months (Line 13b)
Report the total fee-for-service managed care member months by source of payment.
•
A fee-for-service member month is defined as one patient being assigned to a health center or health center
service delivery provider for one month, during which time the patient may receive contractually defined
basic primary care services only from the health center but for whom the services are paid on a negotiated feefor-service basis.
•
There is a relationship between the fee-for-service member months reported on Line 13b and the revenue
reported on Table 9D on Lines 2b, 5b, 8b, and/or 11b.
•
It is common for patients to have their primary care covered by capitation but other services (e.g., behavioral
health or pharmacy) paid separately on a fee-for-service basis as a “carve-out” in addition to the capitation.
DO NOT include member months for individuals who receive “carved-out” services under a fee-for-service
arrangement on Line 13b if those individuals have already been counted for the same month as a capitated
member on Line 13a.
SPECIAL MEDICALLY UNDERSERVED POPULATIONS, LINES 14–26
This section asks for a count of patients from special medically underserved populations, including migratory and
seasonal agricultural workers and their family members, homeless populations, patients who are served by schoolbased service sites, patients who are veterans, and residents of public housing7. Awardees who receive funding
from section 330(g) (MSAW) and section 330(h) (HP) must provide additional information on their migratory and
seasonal agricultural employment and/or housing characteristics.
•
All health centers report these populations, regardless of whether they directly receive special medically
underserved population funding.
•
The special medically underserved populations detailed below are not mutually exclusive. Patients can be
reported in more than one category, as appropriate (e.g., a patient can be reported as both a veteran and
homeless population).
Total Migratory and Seasonal Agricultural Workers and Their Family Members,
Lines 14–16
Total Migratory and Seasonal Agricultural Workers or Their Family Members, Line 16: Report the total
number of patients seen during the calendar year who were migratory and seasonal agricultural workers, family
members of migratory and seasonal agricultural workers, or aged or disabled former migratory agricultural
workers (as described in the statute section 330(g)(1)(B)). All health centers must report on this line, though for
some the number may be zero.
Only health centers that receive section 330(g) (MSAW) funding provide separate totals for migratory and
seasonal agricultural workers on Lines 14 and 15. For section 330(g) awardees, the sum of Lines 14 + 15 = Line
16.
•
7
For migratory and seasonal agricultural workers, report patients who meet the definition of agriculture as
farming in all its branches, as defined by the Office of Management and Budget (OMB)-developed North
American Industry Classification System (NAICS), and include seasonal workers included in codes 111 and
112 and all sub-codes therein, including sub-codes 1151 and 1152.
Residents of public housing refers to patients who are served at a health center located in or immediately accessible to a public housing site.
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•
Migratory and seasonal agricultural workers’ status must be verified at least every 2 years by MSAW
awardees.
Instructions for reporting migratory and seasonal agricultural workers:
•
Migratory Agricultural Workers, Line 14: Report patients whose principal employment is in agriculture
and who establish a temporary home for the purposes of such employment as a migratory agricultural worker,
as defined by section 330(g) of the Public Health Service (PHS) Act. Migratory agricultural workers are
usually hired laborers who are paid piecework, hourly, or daily wages. Include patients who had such work as
their principal employment within 24 months of their last visit during the calendar year, as well as their
family members who have also used the center. The family members may or may not move with the worker
or establish a temporary home.
Note: Agricultural workers who leave a community to work elsewhere are classified as migratory agricultural
workers even when served in their home community, as are those who migrate to a community to work there.
o Include aged and disabled former migratory agricultural workers, as defined in section 330(g)(1)(B), and
their family members. Aged and disabled former migratory agricultural workers include those who were
previously migratory agricultural workers but who no longer work in agriculture because of age or
disability.
•
Seasonal Agricultural Workers, Line 15: Report patients whose principal employment is in agriculture on a
seasonal basis (e.g., picking fruit during the limited months of a picking season), but who DO NOT establish
a temporary home for purposes of such employment. Seasonal agricultural workers are usually hired laborers
who are paid piecework, hourly, or daily wages. Include patients who have been so employed within 24
months of their last visit during the calendar year, as well as their family members who are patients of the
health center.
Note: Seasonal agricultural workers may be employed throughout the year for multiple crop seasons and as a
result might work full-time.
Total Homeless Population, Lines 17–23
Total Homeless Population, Line 23: Report the total number of patients known to have experienced
homelessness at the time of any service provided during the calendar year, even if their housing situation
changed during the year. Include patients on this line who experienced homelessness at any time during the year
and were seen by the health center for services. All health centers must report on this line, though for some the
number may be zero.
Only health centers receiving section 330(h) (HP) funding provide separate totals for patients by housing location
on Lines 17 through 22. For section 330(h) awardees, the sum of Lines 17 through 22 = Line 23.
•
Report patients who lack housing. Include patients whose primary residence during the night is a supervised
public or private facility that provides temporary living accommodations. Include patients who reside in
transitional housing or permanent supportive housing.
•
Children and youth at risk of homelessness, homeless veterans, and veterans at risk of homelessness may be
included.8
Homeless population includes patients who at any point during the calendar year experienced homelessness or
were at risk of homelessness for up to 12 months after they were last documented to experience homelessness.
8
Health centers may use criteria as defined by the U.S. Department of Housing and Urban Development (HUD) to assist in defining “children and youth at
risk of homelessness, homeless veterans, and veterans at risk of homelessness.”
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Housing status is based on the housing arrangement at the first visit during the calendar year when the patient is
identified as experiencing homelessness.
HP awardees will provide detail on patients experiencing homelessness by the type of shelter arrangement the
patients had when they were first encountered for a visit during the calendar year. The following applies when
categorizing patients for Lines 17 through 22:
•
HP awardees must collect housing status at the first visit of the year when the patient was identified to be
experiencing homelessness.
•
Report the patient’s shelter arrangement as of the first visit during the calendar year when the patient was
identified as experiencing homelessness. The shelter arrangement is reported as where the patient was
housed the prior night.
•
Report patients who spent the prior night in a carceral facility, in an institutional treatment program (e.g.,
mental health, substance use disorder [SUD]), or in a hospital based on where they intend to spend the night
after their visit/release. If they DO NOT know, report their shelter arrangement as Street, on Line 20.
•
Shelter, Line 17: Report patients who are living in an organized shelter for individuals experiencing
homelessness. Shelters that generally provide meals and a place to sleep are regarded as temporary and often
limit the number of days or the hours of the day that a resident may stay at the shelter.
•
Transitional Housing, Line 18: Transitional housing units are generally small units (six people is common)
where people transition from a shelter and are provided extended, but temporary, housing stays (generally
between 6 months and 2 years) in a service-rich environment. Transitional housing provides a greater level of
independence than traditional shelters and may require the resident to pay some or all of the rent, take part in
the maintenance of the facility, and/or cook their own meals. Report only those patients who are transitioning
from a homeless environment. DO NOT include those who are transitioning from a carceral facility or those
residing in or transitioning from an institutional treatment program, the military, schools, or other institutions.
•
Doubled Up, Line 19: Report patients who are living with others. The arrangement is considered to be
temporary and unstable, though a patient may live in a succession of such arrangements over a protracted
period. DO NOT include the individual who invites a patient experiencing homelessness to stay in their home
for the night. DO NOT include a co-tenant rental as doubled up.
•
Street, Line 20: Report in this category patients who are living outdoors, in a vehicle, in an encampment, in
makeshift housing/shelter, or in other places generally not deemed safe or fit for human occupancy.
•
Permanent Supportive Housing,9 Line 21a: Permanent supportive housing usually is in service-rich
environments, does not have time limits, and may be restricted to people with some type of disabling
condition.
•
Other, Line 21: Report patients who were housed when first seen during the year and were no longer
homeless, but who were still eligible for the program because they experienced homelessness during the
previous 12 months. Under section 330(h), a health center may continue to provide services for up to 12
months after last documentation as experiencing homelessness to patients whom the health center has
previously served but are no longer in the homeless population as a result of becoming a resident in
permanent housing. Include them in this category. Also include patients who reside in single-room-occupancy
(SRO) hotels or motels and patients who reside in other day-to-day paid housing or other housing programs
that are intended for people experiencing homelessness.
9
Health centers may use criteria as defined by HUD to assist in defining permanent supportive housing.
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•
Unknown, Line 22: Report patients known to be experiencing homelessness whose housing arrangements are
unknown.
•
DO NOT report patients currently residing in a carceral facility or an institutional treatment program as
homeless until they are released to the street with no housing arrangement.
•
DO NOT report patients who are part of the foster system program and are placed with a family, group home,
or in some other arrangement as homeless population.
Total School-Based Service Site Patients, Line 24
All health centers that identified a school-based service site (including at an in-scope mobile unit when it is
parked at or on the grounds of a school) in their scope of project (as documented on Form 5B) are to report the
total number of patients who received health care services at the approved school-based service delivery site(s).
Include patients who received countable visits within any of the service categories (medical, dental, mental health,
SUD, other professional, vision, or enabling) when conducted at an approved school-based service site. All
patient characteristic details are to be collected and reported.
•
Report patients served at in-scope school-based service sites located on school grounds, limited to preschool,
kindergarten, and primary through secondary schools (exclude colleges and universities), that provide on-site
health services.
•
Services are targeted to the students at the school but may also be provided to siblings or parents and may be
provided to school staff or patients residing in the immediate vicinity of the school.
•
DO NOT include, as patients, students who only receive screening services or mass treatment, such as
vaccinations or fluoride treatments, at a school.
•
All health centers that identified a school-based service site in their scope of project must report these
populations, regardless of whether the health center directly received HRSA-administered school-based
service site funding.
Total Veterans, Line 25
All health centers are to report the total number of patients who served in the active military, naval, or air service,
which includes full-time service in the Air Force, Army, Coast Guard, Marine Corps, Navy, Space Force, or as a
commissioned officer of the Public Health Service or National Oceanic and Atmospheric Administration. Also,
include patients who served in the National Guard or Reserves on active-duty status.
Include this question in the patient information/intake form at each service delivery site.
•
Report only those who affirmatively indicate they previously served in these branches of the military or
armed forces.
•
DO NOT report patients who do not respond, regardless of other indicators.
•
DO NOT report veterans of other nations’ militaries, even if they served in wars in which the United States
was also involved.
•
DO NOT report military members who served on active duty (full-time status in their military capacity) at the
time of their last visit during the year.
•
DO NOT include family members or other Veterans Affairs beneficiaries who are not veterans.
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Total Residents of Public Housing, Line 26
All health centers are to report all patients seen at a service delivery site located in or immediately accessible
to public housing, regardless of whether the patients are residents of public housing or the health center receives
funding under section 330(i) (RPH).
•
Report patients on this line if they are served at health center service delivery sites that meet the statutory
definition for the RPH funding (located in or immediately accessible to public housing).
•
Report all patients seen at the health center service delivery site if it is located in or immediately accessible to
agency-developed, -owned, or -assisted low-income housing, including mixed-finance projects.
•
This is the only field in the UDS Report that requires you to provide a count of all patients based on the
health center service delivery site’s proximity to public housing.
•
DO NOT consider Section 8 housing units that receive no public housing agency support other than Section 8
housing vouchers as public housing.
Note: Not all patients served at service delivery sites located in or immediately accessible to public housing are
themselves residents of public housing, but they are to be included in the count.
FAQ FOR TABLE 4
1.
Do we determine a patient’s income relative to the FPG based on the location of the health center or
based on the residence of the patient?
Use the FPG based on the location of the health center. All states (except Alaska and Hawaii) and the U.S.
territories use the same standard poverty guidelines. For patients being served in Alaska or Hawaii, use the
FPG established for those locations.
2.
Patients who are experiencing homelessness or who are migratory and seasonal agricultural workers
generally DO NOT have income verification. Can we report them as having income at 100% and below
poverty?
No. You can report them as having “Unknown” income, but not as having income below poverty unless you
verify this at least annually. Subject to your health center’s financial policies and procedures, you may
document their income in your system based on their verbal attestation of their income.
3.
We serve students at a school-based service site. They often DO NOT know what insurance they have,
if any, and they have no information on their family’s/household’s income. Can we report them as
having income at 100% and below poverty and Uninsured?
No. You may not report them as having income below poverty and Uninsured. Obtain insurance information
from the parents or guardians of students served at school-based service sites at the same time that you collect
consent to treat, unless they are exclusively receiving minor consent services. Minor consent services are
defined by state law and are generally limited to a very specific range of services, such as those related to
contraception, sexually transmitted diseases, and mental health. Not all states provide for them. For all other
services, children will require parental consent, and the consent form should include income and insurance
information.
Note: Subject to the health center’s policies and procedures, it is acceptable to ask for this information and to
assure parents that you will not bill the insurance without their knowledge. If you DO NOT obtain the
family’s/household’s income, report the child as having “Unknown” income. The patient’s health insurance
information is required to be collected, even if it is not billed.
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4.
If a patient is seen only for dental care, do we report the patient’s dental insurance on Lines 7–12?
No. Table 4 reports only patients’ medical coverage. All health centers must collect medical coverage
information from all patients, even if they have not been provided medical services.
5. Our state is using Medicaid expansion provisions to assist patients with buying private insurance.
Should we count them as Medicaid or Private?
If patients are Medicaid expansion patients, report them as Medicaid, Line 8a (this may require looking for
specific plan numbers or other identifying characteristics in patients’ insurance enrollment). If you are unable
to identify Medicaid expansion patients, report them as Private, Line 11.
6. Do we classify patients in the insurance section as Uninsured if their medical insurance did not pay for
the visit?
No. Always report patients based on their primary medical care insurance, even if the insurance did not pay or
you are unable to bill for the service. Some examples follow:
•
Report a patient with Medicare who was seen for a dental visit that was not paid for by Medicare as
having Medicare for this table.
•
Report a patient with private insurance who had not reached their deductible as a Private Insurance
patient.
7. Is it possible to have more members in one month (average) than total patients in an insurance
category?
It is possible for the number of member months for any one payer (e.g., Medicaid) to exceed 12 times the
number of patients reported on the corresponding insurance line, especially when patients are enrolled in the
managed care plan but they did not come to the health center during the calendar year. As a rule, there is a
relationship between the member months reported on Lines 13a and 13b and the insured patients reported on
Lines 7 through 11.
8. If we do not receive direct HP, MSAW, or RPH funding, do we need to report the total number of
special medically underserved population patients served?
Yes. Even health centers that DO NOT receive grant funding for special medically underserved populations
are required to complete the following:
•
Line 16 (the total number of patients seen during the calendar year who were migratory and seasonal
agricultural workers or their family members)—but not Lines 14 and 15,
•
Line 23 (total number of patients known to be in the homeless population at any time of the year and
received services during the calendar year)—but not Lines 17–22,
•
Line 24 (patients served at a school-based service site),
•
Line 25 (veterans), and
•
Line 26 (total residents of public housing).
The housing status details on Lines 17–22 are grayed out if you did not receive HP funding—only enter the
total on Line 23.
The migratory and seasonal agricultural workers details on Lines 14 and 15 are grayed out if you did not
receive MSAW funding—only enter the total on Line 16.
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9. What timing determines a patient’s homeless status and shelter arrangement?
For all health centers (regardless of HP funding status), include the total number of patients who experienced
homelessness at any point during the year and received services during the year on Line 23.
For awardees that receive HP funding, continue to count patients seen who are no longer experiencing
homelessness due to becoming residents of permanent housing for 12 months after their last visit as homeless.
For awardees that receive HP funding, report all patients experiencing homelessness by their shelter
arrangement on Lines 17–22.
Asking health centers to report homeless population by their sheltering arrangements as of their first visit
during the calendar year is intended to help health centers determine to which shelter arrangement they should
report a patient if shelter status changes during the year.
10. Who should be reported as Residents of Public Housing on Line 26?
Report the total number of patients who were served at any health center service delivery site that you
consider (based on the health center’s determination if any service delivery locations meet the statutory
definition for RPH) to be located in or immediately accessible to public housing, regardless of whether or not
the health center receives funding under section 330(i) (RPH), and regardless of whether or not patients
resided in public housing. This is a site-based count, and the patient’s address or residence in public housing
is not to be considered.
11. We currently ask if a patient is a veteran as part of the registration process, but we are concerned that
not all veterans are responding accordingly. Are there suggestions?
Yes. The way the question is asked makes a difference, and improving the wording can improve accuracy in
the patients’ response to veteran status. For instance, health centers should ask, “Have you served in the
United States military, armed forces, or uniformed services?” rather than simply asking, “Are you a
veteran?” The broader phrasing captures those who may not identify as veterans but have served, including
individuals from the U.S. Air Force, Army, Coast Guard, Marines, Navy, Space Force, National Guard,
Reserves, or the U.S. Public Health Service and National Oceanic & Atmospheric Association.
12. Are patients who were dishonorably discharged or released considered veterans?
No. Only patients who were discharged or released under conditions other than dishonorable are considered
and reported as veterans.
13. Can patients served by mobile units at schools be considered school-based service site patients?
Patients who receive a countable visit(s) within any of the seven service categories at an approved schoolbased service site are considered school-based service site patients. This includes in-scope mobile units that
serve patients on the grounds of a school.
14. We have a nurse who provides case management and other enabling services to students at our schoolbased service site. How should we report those visits, the patients, and personnel on the UDS Report?
If the services provided by a provider during an encounter meet the countable visit definition, report the
patient(s) and the visit(s) on the UDS Report.
Case management (which is achieved when patients are assisted in the management of their health-related
needs, including assessment of patient medical and/or social service needs; establishment of service plans;
and maintenance of referral, tracking, and follow-up systems) and patient health education are the only
countable enabling services, assuming the full UDS countable visit definition is met. Other enabling services,
such as outreach, transportation, community health, and interpretation DO NOT count as visits in the UDS.
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In this case, when the nurse provides case management (rather than medical care services) as defined above,
report the portion of this personnel’s FTE when dedicated as a case manager and the case management
(enabling) visit(s) on Table 5, Line 24.
In addition, report the total number of patients who had a countable visit within any of the seven service
categories (e.g., medical, mental health, enabling) at an approved in-scope school-based service delivery
site(s) on Table 4, Line 24.
15. Do the totals need to equal other sections or tables?
The following totals must be equal across tables and sections:
•
Patients by ZIP Code Table, Column B must equal Table 4, Line 7, Columns A and B.
•
Patients by ZIP Code Table, Column C must equal Table 4, Lines 8 and 10, Columns A and B.
•
Patients by ZIP Code Table, Column D must equal Table 4, Line 9, Columns A and B.
•
Patients by ZIP Code Table, Column E must equal Table 4, Line 11, Columns A and B.
•
The sum of Table 3A, Line 39, Columns A and B (total patients by age and sex) must equal Table 3B,
Line 8, Column D (total patients by race and Hispanic, Latino/a, or Spanish ethnicity); Table 4, Line 6
(total patients by income); and Table 4, Line 12, Columns A and B (total patients by medical insurance
status).
•
The sum of Table 3A, Lines 1–18, Columns A and B (total patients age 0–17 years) must equal Table 4,
Line 12, Column A (total patients age 0–17 years).
•
The sum of Table 3A, Lines 19–38, Columns A and B (total patients age 18 and older) must equal Table
4, Line 12, Column B (total patients age 18 and older).
•
The sum of Table 3A, Line 39, Columns A and B (total patients by age and sex) must equal Table 4, Line
12, Columns A and B (total patients by insurance status).
The same is true for each of the Grant Reports submitted.
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2025 UDS MANUAL | Instructions for Table 4
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TABLE 4: SELECTED PATIENT CHARACTERISTICS
Calendar Year: January 1, 2025, through December 31, 2025
Line
Income as Percentage of Poverty Guideline
1
2
3
4
5
6
100% and below
101–150%
151–200%
Over 200%
Unknown
Line
Primary Third-Party
Medical Insurance
7
8a
8b
8
9a
9
10a
10b
10
11
12
TOTAL (Sum of Lines 1–5)
18 and older
(b)
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