Payment Limit under the AIR

20.2 - Payment Limit under the AIR (Rev. 13264, Issued:06-09-25; Effective: 06-02-25; Implementation: 06-02-25) For RHCs that bill under the AIR, Medicare pays 80 percent of the RHC AIR, subject to a payment limit. At the end of the cost reporting period, the MAC determines the total payment due and reconciles payments made during the period with the total payments due. RHCs that receive payments under the AIR must submit an annual cost report to establish their payment rate. If a RHC is in its initial reporting period, the MAC calculates an interim rate based on a percentage of the per-visit limit, which is then adjusted when the cost report is filed. For information on cost reporting requirements, see the Medicare Provider Reimbursement Manual (PRM), at http://www.cms.gov/Regulations-and- Guidance/Guidance/Manuals/Paper-Based-Manuals.html