Fqhc And Rhc Services: Reimbursement Methodology

01. Payment. Payment for FQHC and RHC services must be made in accordance with Section 702 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, P.L. 106-554, 42USC Section 1396a(bb), Subsections (1) through (4). (7-1-26) 02. FQHC or RHC Encounter. Each contact with a separate discipline of health professional (medical, mental or dental), on the same day at the same location, is reimbursed as a separate encounter. All contact with all practitioners within a disciplinary category (medical, mental or dental) on the same day is a single encounter. (7-1-26) a. Reimbursement for services is limited to one (1) encounter per discipline per participant per day. (7-1-26) b. An additional encounter may be reimbursed, if the encounter is caused by an illness or injury that occurs later than the first encounter and requires additional diagnosis or treatment. (7-1-26) c. The encounter rate does not include drugs for biologicals which cannot be self-administered, long- acting reversible contraception (LARC) or non-surgical transcervical permanent female contraceptive devices. (7-1-26)