Medicare Benefit Policy Manual (Pub. 100-02), Ch. 13 § 70
RHC and FQHC Payment
70 - RHC and FQHC Payment
(Rev. 252, Issued: 12-07-18, Effective: 01-01-19, Implementation: 01- 02-19)
RHCs and FQHCs must submit claims for RHC or FQHC services under the RHC or
FQHC payment methodologies and are not authorized to submit claims under the
Physician Fee Schedule (PFS) for RHC or FQHC services. Newly certified RHCs or
FQHCs should work with their A/B MAC to ensure that all claims filed for RHC or
FQHC services are paid as RHC or FQHC claims as of the date of their certification.