RHC Services

50.1 - RHC Services (Rev. 13600; Issued: 02-20-26; Effective: 01-01-26; Implementation:03-23-26) RHC services include: • Physicians' services, as described in section 110; • Services and supplies incident to a physician’s services, as described in section 120; • Services of NPs, PAs, and CNMs, as described in section 130; • Services and supplies incident to the services of NPs, PAs, and CNMs, as described in section 140; • CP and CSW services, as described in section 150; • MFT and MHC services, as described in section 150; • Services and supplies incident to the services of CPs and CSWs, as described in section 160; • Services and supplies incident to the services of MFTs and MHCs, as described in section 160; • Visiting nurse services to patients confined to the home, as described in section 190; • Certain care coordination services, as described in section 230; • Certain virtual communication services, as described in section 240; and • Intensive Outpatient Program (IOP) Services, as described in section 250. RHC services also include certain preventive services when specified in statute or when established through the National Coverage Determination (NCD) process and not specifically excluded (see section 220 – Preventive Health Services). These services include: • Influenza, Pneumococcal, Hepatitis B, COVID-19 vaccinations, and covered monoclonal antibody products used as pre-exposure prophylaxis prevention of COVID-19; • IPPE; • Annual Wellness Visit (AWV); and • Medicare-covered preventive services recommended by the U.S. Preventive Services Task Force (USPSTF) with a grade of A or B, as appropriate for the individual. • Drugs Covered as Additional Preventive Services (DCAPS) and related supply and administration fees. The professional component of the IPPE, AWV, and other qualified preventive services is paid based on the AIR.