Q&A: RHC services before and after hours

Q. How can rural health clinics (RHC) bill for services provided before or after posted hours?

A. Services that are provided before or after the posted hours of operation can be billed by the clinic only when provided by a practitioner that is compensated by the RHC and those services are reported on the cost report (Medicare Benefit Policy Manual, Chapter 13, §40.2, 2016). If the services are provided before or after the posted hours of operation in accordance with the RHC’s policies, procedures, and employment contracts, and are not reported on the cost report, the practitioner may separately bill those services to Part B. The appropriate Medicare coverage policies and payment methodology will apply. All costs associated with non-RHC services billed separately to Part B must be removed from the cost report, including costs associated with space, equipment, supplies, facility overhead, and personnel (Medicare Benefit Policy Manual, Chapter 13, §60, 2016).

For more information, see The Essential Rural Health Clinic Billing and Management Guide.

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