Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 30.1.1
Rural Health Clinics
30.1.1 - Rural Health Clinics
(Rev. 1, 10-01-03)
PM A-99-8, Rev. 810, CR 1133, PM A-00-30
Rural Health Clinics (RHCs) must furnish the following laboratory services to be approved as an RHC.
However, these and other laboratory services that may be furnished are not included in the encounter rate and
must be billed separately:
•
Chemical examinations of urine by stick or tablet method or both;
•
Hemoglobin or hematocrit;
•
Blood sugar;
•
Examination of stool specimens for occult blood;
•
Pregnancy tests; and
•
Primary culturing for transmittal to a certified laboratory (No CPT code available).
Effective January 1, 2001, freestanding RHCs/Federally Qualified Health Centers (FQHCs) bill all laboratory
services to the A/B MAC (B), and provider based RHCs/FQHCS bill all laboratory tests to the A/B MAC (A)
under the host provider’s bill type. In either case payment is made under the fee schedule. HCPCS codes are
required for laboratory services. (See §40.4 for details on RHC billing.)