Effective: January 1, 2012 Implementation: January 3, 2012
MM7533 – CY 2012 Medicare Rural Health Clinic and Federally Qualified Health Center Payment Rate Increases –
Change Request (CR) 7533 provides instructions for the Calendar Year (CY) 2012 payment rate increases for RHC and Federally Qualified Health Center (FQHC) services.
CMS is increasing the CY payment rates for RHCs and FQHCs effective for services on or after January 3, 2012, through December 31, 2012 (i.e., CY 2012) as follows:
RHC upper payment limit – Per visit is increased from $78.07 to $79.48. The 2012 RHC rate reflects a 1.8 percent increase over the 2011 payment limit in accordance with the rate of increase in the Medicare Economic Index (MEI).
FQHC upper payment limit – Per visit for urban FQHCs is increased from $126.22 to $128.49. The maximum Medicare payment limit per visit for rural FQHCs is increased from $109.24 to $111.21. The 2012 FQHC rates reflect a 1.8 percent increase over the 2011 rates in accordance with the rate of increase in the MEI.
Medicare contractors will not retroactively adjust individual RHC/FQHC bills paid at previous upper payment limits. However, they have the discretion to make adjustments to the interim payment rate or a lump sum adjustment to total payments already made to take into account any excess or deficiency in payments to date.
Education
RHC Policy and Billing Web-Based Training (WBT) – December 6, 2011.
(This Web-based training is intended to increase providers’ overall knowledge of RHC policy and billing)
Did You Know? TrailBlazer provides recorded versions of most WBT sessions. Many providers and their staff find it difficult to attend Medicare trainings while keeping up with the demands of work. Encore presentations are posted on our Web site within a week following the training and are available 24/7. This means that you can take the encore presentation at your convenience. Visit the Encore WBT page and take advantage of this training today!
ResourcesBookmark or add the RHC Web page to your favorites for a one-stop source of information. This page includes links to related notices, FAQs, upcoming events, publications and CMS resources.
