Resources

CMS Internet Manuals HC Program

RHC Medicare Benefit
http://www.cms.hhs.gov/manuals/Downloads/bp102c13.pdf

Examples of information that can be found in this document include:

  • Rural Health Clinics (RHCs) Defined
  • Rural Health Clinic Service Defined
  • Physician Services
  • Services and Supplies Furnished Incident to Physician’s Services
  • Nurse Practitioner, Certified Nurse Midwife, and Physician Assistant Services
  • Services and Supplies Incident to Nurse Practitioners, Certified Nurse Midwives
  • Conditions for Coverage of Visiting Nurse Services
  • Clinical Psychologist Services Away and at the RHC
  • Clinical Social Worker (CSW) Services Away and at the RHC

RHC Medicare Claims Processing
http://www.cms.hhs.gov/manuals/downloads/clm104c09.pdf

Examples of information that can be found in this document include:

  • General Differences Between RHCs and FQHCs
  • Method of Medicare Payment for RHC and FQHC Services
  • Annual Reconciliation With Cost Report
  • Allowable Costs
  • Deductible and Coinsurance
  • Mental Health Services Limitftp://ftp.hrsa.gov/ruralhealth/RHCmanual1.pdf
  • Determining How Much to Charge Patient Before Billing Is Submitted for Part B Payment
  • Laboratory Services
  • FI/Carrier Coordination
  • Agreements Between CMS and RHC/FQHC
  • Content and Terms of Agreements
  • Termination of Agreement

Starting a Rural Health Clinic – A How-To Manual(pdf)

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