Q&A: Billing for RHC services outside the scope of certification

Q. How would a rural health clinic (RHC) bill for services it provided beyond its scope?

A. An RHC may provide other services beyond the scope of its certification and the RHC benefit. If the service is covered under another Medicare benefit category, the RHC must separately bill Part B under the payment rules that apply to that service (e.g., Medicare Physician Fee Schedule [MPFS] or other methodology). All costs associated with non-RHC services (e.g., overhead, staff, supplies, etc.) are not considered to be allowable costs and may not be reported on the RHC’s cost report.

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

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