Billing Requirements for RHCs and FQHCs

60 - Billing Requirements for RHCs and FQHCs (Rev. 13264, Issued:06-09-25; Effective: 06-02-25; Implementation: 06-02-25) RHCs and FQHCs are institutional claims and are submitted to the MAC on TOB 71X and 77X. Generally, only those services that are included in the RHC and FQHC benefits are billed on these claims. • The RHC and FQHC benefits are defined in Pub. 100-02, Medicare Benefit Policy Manual, Chapter 13 (http://www.cms.hhs.gov/manuals/Downloads/bp102c13.pdf.) All professional services in the RHC and FQHC benefit are paid through the AIR system or the FQHC PPS payment for each patient encounter or visit. Technical services (or technical components of services with both professional and technical components) are not billed on RHC/FQHC claims.