Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.5

Rural Health Clinic (RHC) Billing

Last amended: 2003Year: 2003Length: 157 wordsOfficial source
40.5 - Rural Health Clinic (RHC) Billing (Rev. 1, 10-01-03) B3-3628 For independent RHCs, laboratory services provided in the RHC’s laboratory are not included in the all- inclusive rate payment to the RHC and may be billed separately to the A/B MAC (B). This includes the six basic laboratory tests required for certification as well as any other laboratory tests provided in the RHC laboratory. Note: If the RHC sends laboratory services to an outside laboratory, the outside laboratory bills the A/B MAC (B) for the tests. If the RHC laboratory becomes certified as a clinical laboratory, it bills all laboratory tests performed in its laboratory to the laboratory’s A/B MAC (B). Laboratory tests are not included as RHC costs nor as part of the RHC all-inclusive rate payment. For provider based RHCs the rules in the preceding paragraph apply with the following exception. The provider bills tests provided in its laboratory to the A/B MAC (A).
Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.5: Rural Health Clinic (RHC) Billing | Justis AI