Rural Health Clinics Center

• The Medicare Benefit Policy Manual, Chapter 13 - Rural Health Clinics (RHC) and Federally Qualified Health Centers (FQHC) has been completely re-organized and revised to better access information, improve clarity and understanding, update all current information on payment policies for RHCs and FQHCs, and include updated links to websites and resources. The implementation date of the new manual was March 1, 2013.
• Vaccination is the Best Protection Against the Flu [PDF, 414KB]
• SE1039 – Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Billing Guide
• Medicare Rural Health Clinics Waiver of Coinsurance and Deductible Claim Processing Issue:  The Centers for Medicare & Medicaid Services (CMS) has identified an issue when Healthcare Common Procedure Coding System (HCPCS) codes are reported for preventive services recommended by the United States Preventive Services Task Force (USPSTF) with a grade of A or B on Rural Health Clinic claims (71X) for dates of service on or after January 1, 2011. Since the additional revenue line(s) are not separately payable, the contractors have been instructed to move the charges associated with these revenue lines to the non covered field and to override reason code 31577. This will allow the claim to continue processing and not delay payments. After the changes for CR 7208, transmittal 2122, are implemented on April 4, 2011, contractors will mass adjust these claims to ensure the charges are reflected as covered. Providers should not attempt to resubmit affected claims as their FI or MAC will be initiating adjustments for the sole purpose of correcting the charges. Providers should anticipate the initiation of these adjustments within 30 calendar days after the implementation of CR 7208.

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