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Rural Health Clinics (RHCs) Resources

Selected recent or important resources focusing on Rural Health Clinics (RHCs).

Sliding Fee Scale Discount Guide for CAHs and RHCs
Contains concepts and guidance for Critical Access Hospital (CAH) and Rural Health Clinic (RHC) executives and management teams in developing a sliding fee scale discount program. Explains how these programs relate to Internal Revenue Code Section 501(r) compliance and participation in the National Health Service Corps (NHSC). Includes an example of a sliding fee schedule.
Author(s): Ralph J. Llewellyn
Date: 09/2017
Type: Website
Sponsoring organization: National Rural Health Resource Center
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Rural Health Clinic and Federally Qualified Health Center - Medicare Benefit Policy Manual Chapter 13 Update
Highlights key revisions effective March 9, 2017 made by the Centers for Medicare & Medicaid Services (CMS) to Chapter 13 of the Medicare Benefit Policy Manual for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) submitting claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries.
Date: 12/2016
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Health Clinics (RHCs)
Printable map that shows the location of RHCs nationwide by state. Data source: HRSA Data Warehouse, U.S. Department of Health and Human Services, December 2016.
Date: 12/2016
Type: Map/Mapping System
Sponsoring organization: Rural Health Information Hub
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Rural Health Clinics (RHCs) Healthcare Common Procedure Coding System (HCPCS) Reporting Requirement and Billing Updates
Provides information to help Rural Health Clinics (RHCs) meet the requirements in reporting Healthcare Common Procedure Coding System (HCPCS) codes when submitting claims to the Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries.
Date: 10/2016
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Estimate the Annual Economic Impact of an Independent Rural Health Clinic
Study featuring two scenarios, the first exploring average economic employment and labor income impacts of an independent rural health clinic, and the second looking at the same scenario without direct physician employment.
Author(s): Fred C. Eilrich, Gerald A. Doeksen, Cheryl F. St. Clair
Date: 10/2016
Type: Document
Sponsoring organization: National Center for Rural Health Works
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Identifying Rural Health Clinics in Medicaid Data
Describes and compares 6 different tested methods for identifying Rural Health Clinics (RHCs) within Medicaid claims, using data from 4 states, as a technique to better understand Medicaid enrollees’ use of RHC services.
Author(s): Marisa Domino, Seth Tyree, Regina Rutledge, Mark Holmes
Date: 05/2016
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Characteristics of Medicaid Beneficiaries Who Use Rural Health Clinics
Describes the population of Rural Health Clinic (RHC) users from North Carolina, Georgia, California, and Texas to assist in policy making and in research, using CMS Medicaid claim data from RHCs, or from healthcare providers practicing under the RHC program.
Author(s): Marisa Domino, Seth Tyree, Regina Rutledge, et al.
Date: 05/2016
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Medicare Shared Savings Program and Rural Providers
Provides an overview of Accountable Care Organizations (ACOs) for rural providers. Reports that the Medicare Shared Savings Program will reward Accountable Care Organizations that lower their growth in healthcare costs while meeting performance standards on quality of care. The regulations provide for FQHCs and RHCs to participate in the Shared Savings Program by becoming their own ACOs, or by joining an ACO as an ACO participant along with other organizations.
Date: 03/2016
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Pilot Testing a Rural Health Clinic Quality Measurement Reporting System
Policy brief with results of a study focusing on assessing the feasibility and utility of the reporting system and quality measures for 61 participating Rural Health Clinics in 6 states. Includes statistics related to core measures and their perceived value as well as challenges or barriers to their use.
Author(s): John Gale, Anush Hansen, David Hartley, Andrew Coburn
Date: 02/2016
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Required Billing Updates for Rural Health Clinics
Guidance for Rural Health Clinic billing related to inclusion of Healthcare Common Procedure Coding System (HCPCS) codes for services provided to Medicare beneficiaries. Requirements are implemented April 1, 2016 and effective April 4, 2016.
Location: MLN Matters, MM9269
Date: 02/2016
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Benefit Policy Manual: Chapter 13 - Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services
Revised regulations, as of January 15, 2016, regarding Medicare payment policies for Rural Health Clinics (RHC) and Federally Qualified Health Centers (FQHC).
Date: 01/2016
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Guidance on the Physician Quality Reporting System (PQRS) 2014 Reporting Year and 2016 Payment Adjustment for Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs)
Lists frequently asked questions concerning Rural Health Clinics, Federally Qualified Health Centers, and Critical Access Hospitals who submit claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries.
Date: 2016
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Chronic Care Management (CCM) Services for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
Provides instructions for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) on how to submit claims for chronic care management services according to the RHC All-Inclusive Rate and the FQHC Prospective Payment System, effective January 1, 2016.
Date: 11/2015
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Are You Ready to Begin a Capital Project? A Guide, Toolkit and Resources for Critical Access Hospitals and Rural Health Centers
Determines organizational readiness of Critical Access Hospitals and Rural Health Clinics as they proceed through the process of developing capital projects, and helps them prevent any drawbacks due to an inadequate plan. The manual is divided into two major sections: Self-assessment provides tools to identify current capabilities and weaknesses that can be used as a starting point to build a capital project; and External Influences provides tools to examine patient population and the community’s demand for services and healthcare trends to ensure the capital project is responsive to current and future needs.
Date: 11/2015
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2016
Presents the final rule effective January 1, 2016 regarding revisions to the Medicare physician fee schedule and other Medicare Part B payment policies, and their affect on Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).
Date: 11/2015
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Performance Measurement for Rural Low-Volume Providers
Identifies challenges to measuring healthcare performance among low-volume rural providers, and presents recommendations to meet these challenges. Primary focus is on finding appropriate quality measures for use within Centers for Medicare and Medicaid Services' (CMS) pay-for-performance programs, and encouraging rural participation in CMS quality improvement initiatives.
Date: 09/2015
Type: Document
Sponsoring organization: National Quality Forum
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Adoption and Use of Electronic Health Records by Rural Health Clinics: Results of a National Survey
Results of a 2013 web-based national survey of 1,479 Rural Health Clinics (RHCs) assessing implementation of Electronic Health Records (EHR) technology. Includes statistics with breakdowns by geographic region, clinic ownership type, percentage of usage, and types of barriers to EHR acquisition and implementation.
Author(s): John Gale, Zach Croll, David Hartley
Date: 09/2015
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Participation of Rural Health Care Providers in Accountable Care Organizations: Early Indications
Describes the characteristics of Rural Health Clinics (RHCs) in the southeastern part of the U.S. and the populations they serve. Compares these traits to other regions in the country, and how the differences may influence their decision to participate in an Accountable Care Organization (ACO).
Author(s): Judith Ortiz, Richard A. Hofler, Yi-Ling Lin, Richard Berzon
Location: Health Care Management Review, (34(3), 255-264
Date: 07/2015
Type: Document
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Revisions to State Operations Manual (SOM) Appendices A, G, L and T Related to Hospitals, Rural Health Clinics, Ambulatory Surgical Centers and Swing Beds
Revises the Centers for Medicare & Medicaid Services' State Operations Manual (SOM) to reflect regulation changes affecting Hospitals, Rural Health Clinics, Ambulatory Surgical Centers and Swing Beds in hospitals.
Date: 04/2015
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under
Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 01/2015
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Health Clinic Readiness for Patient-Centered Medical Home Recognition: Preparing for the Evolving Healthcare Marketplace
Discusses the results from a survey of rural health clinics (RHC) that identified their capability to be eligible as a NCQA Patient-Centered Medical Home (PCMH) and examines the need for technical assistance and support of RHCs in the development of the PCMH model.
Author(s): John Gale, Zach Croll, David Hartley, Andrew F. Coburn
Date: 01/2015
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Guidance on the Physician Quality Reporting System (PQRS) 2013 Reporting Year and 2015 Payment Adjustment for Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs)
Lists frequently asked questions concerning Rural Health Clinics, Federally Qualified Health Centers, and Critical Access Hospitals who submit claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries.
Date: 2015
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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42 CFR Part 491, Subpart A - Rural Health Clinics: Conditions for Certification; and FQHCs Conditions for Coverage
Establishes the conditions Rural Health Clinics and Federally Qualified Health Centers must meet to qualify for reimbursement under Medicare, as well as those that Rural Health Clinics must meet to qualify for reimbursement under Medicaid.
Date: 10/2014
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS Has Yet to Enforce a Statutory Provision Related to Rural Health Clinics
A study to determine the extent to which Rural Health Clinics (RHCs) no longer meet the location requirements and whether the Centers for Medicare & Medicaid Services (CMS) has taken steps to address a prior Office of Inspector General (OIG) recommendation to issue regulations defining the criteria for RHCs to be deemed “essential providers.”
Date: 09/2014
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Medicare Billing Information for Rural Providers and Suppliers
Provides Medicare billing charts and information on where to submit claims for Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), Skilled Nursing Facilities, Home Health Agencies, Critical Access Hospitals, and Swing Bed services.
Date: 08/2014
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Claims Processing Manual: Chapter 9 - Rural Health Clinics / Federally Qualified Health Centers
Describes the differences between Rural Health Clinics and Federally Qualified Health Centers. Identifies the rules and regulations for processing Medicare claims.
Date: 07/2014
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Program; Prospective Payment System for FQHCs; Changes to Contracting Policies for RHCs; and Changes to Clinical Laboratory Improvement Amendments of 1988 Enforcement Actions for Proficiency Testing Referral
The final rule with comment period that implements the methodology and payment rates for a prospective payment system (PPS) for Federally Qualified Health Centers (FQHCs) services beginning October 1, 2014 under Medicare Part B, in compliance with the Affordable Care Act (ACA). Identifies the policy allowing Rural Health Clinics (RHCs) to contract with nonphysician practitioners when statutory requirements for employment of nurse practitioners and physician assistants are met, and incorporated are other technical changes to FQHC and RHC regulations. Changes to the Clinical Laboratory Improvement Amendments of 1988 enforcement actions for proficiency testing referral are included.
Date: 05/2014
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Safety Net Clinics Serving the Elderly in Rural Areas: Rural Health Clinic Patients Compared to Federally Qualified Health Center Patients
Compares the distribution of Rural Health Clinics (RHCs) and nonmetro Federally Qualified Health Centers (FQHCs). Looks at how the Medicare populations served by these types of facilities differ.
Author(s): Andrea D. Radford, Victoria A. Freeman, Denise A. Kirk, Hilda A. Howard, Mark Holmes
Date: 05/2014
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Rural Health Clinics
Summarizes the development and current status of Rural Health Clinics. Identifies the issues of concern and provides recommendations regarding those issues.
Author(s): Gail Nickerson
Date: 04/2014
Type: Document
Sponsoring organization: National Rural Health Association
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Meaningful Use of the Electronic Health Record by Rural Health Clinics (Policy Brief)
Fifty-nine percent of RHCs report having an EHR and independent RHCs were more likely than hospital-based RHCs to have an EHR. Common barriers to EHR adoption by RCHs include acquisition and maintenance costs, lack of capital, and potential productivity or income loss during transition.
Author(s): John A. Gale, David Hartley, Zach Croll
Date: 02/2014
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Meaningful Use of Electronic Health Records by Rural Health Clinics (Working Paper)
Identifies the rates of electronic health record (EHR) adoption among a national random sample of Rural Health Clinics (RHCs), and the extent to which RHCs that have adopted an EHR system are likely to achieve Stage 1 meaningful use.
Author(s): John A. Gale, David Hartley, Zach Croll
Date: 02/2014
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Understanding Adoption of a Personal Health Record in Rural Health Care Clinics: Revealing Barriers and Facilitators of Adoption including Attributions about Potential Patient Portal Users and Self-reported Characteristics of Early Adopting Users
Examines patient survey data from Rural Health Clinics providing a comparison of patients who are early adopters of personal health records (PHRs) to those who do not use PHRs.
Author(s): Jorie Butler, Marjorie Carter, Candace Hayden, et al.
Date: 11/2013
Type: Document
Sponsoring organization: American Medical Informatics Association
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Trends in Rural Health Clinics and Needs During U.S. Health Care Reform
Describes the changes that have occurred in RHCs and the characteristics that have remained the same over a 10 year period. Identifies some of the needs of RHCs as they transition through healthcare reform.
Author(s): Judith Ortiz, Natthani Meemon, Yue Zhou, Thomas T.H. Wan
Location: Primary Health Care Research & Development, 14(4), 360-366
Date: 10/2013
Type: Document
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A Quick Guide for Rural Health Clinics
Provides guidelines to assist Rural Health Clinics (RHCs) in applying for National Health Service Corps (NHSC) site approval.
Date: 08/2013
Type: Document
Sponsoring organization: National Health Service Corps
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Accountable Care Organizations: Benefits and Barriers as Perceived by Rural Health Clinic Management
Describes results of a survey, focus groups, and phone interviews with Rural Health Clinic management personnel regarding benefits of and barriers to RHC participation in Accountable Care Organizations.
Author(s): Judith Ortiz, Angeline Bushy, Yue Zhou, Hong Zhang
Location: Rural and Remote Health, 13, 2417
Date: 06/2013
Type: Document
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Profile of Rural Health Clinics: Clinic & Medicare Patient Characteristics: Review of 2009 Medicare Outpatient Claims Data
Presents a summary of the geographic distribution and clinic-level characteristics of rural health clinics, as well as an overview of the Medicare beneficiaries they served.
Author(s): Andrea D. Radford, Denise A. Kirk, Hilda A. Howard, Mark Holmes
Date: 03/2013
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Profile of Rural Health Clinics: Medicare Payments & Common Diagnoses: Review of 2009 Medicare Outpatient Claims Data
Presents a summary profile of Medicare billing and reimbursement activity for independent and provider-based rural health clinics.
Author(s): Andrea D. Radford, Denise A. Kirk, Hilda A. Howard
Date: 12/2012
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Status of PPS Implementation in the Children's Health Insurance Program, State Policy Report #42
Reviews the progress achieved since the implementation of the Children’s Health Insurance Program (CHIP) prospective payment system (PPS) for federally qualified health centers and rural health centers. Highlights current efforts at the state level to implement CHIP PPS.
Author(s): Dawn McKinney, Asha Cesar, Adam Sampiev
Date: 11/2012
Type: Document
Sponsoring organization: National Association of Community Health Centers
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Medicare Shared Savings Program: Accountable Care Organizations, Final Rule
Summarizes segments of the rule on Medicare Accountable Care Organizations (ACOs) as they affect family practitioners in small and medium-sized practices, including Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs).
Date: 11/2011
Type: Document
Sponsoring organization: American Academy of Family Physicians
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Starting a Rural Health Clinic: A How-To Manual
Detailed guide describing the Rural Health Clinic (RHC) program. Includes instructions on how to determine eligibility and financial feasibility of RHC status and how to apply to become an RHC. Includes a sample RHC policies and procedures manual.
Date: 04/2004
Type: Document
Sponsoring organization: Federal Office of Rural Health Policy
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Rural Health Clinic Technical Assistance Series
Series of recorded webinars presenting information about operational and policy issues related to the Rural Health Clinic (RHC) program. Webinars are generally held five times annually, last about one hour, and include a 15-minute question and answer session.
Type: Video/Multimedia
Sponsoring organizations: Federal Office of Rural Health Policy, National Association of Rural Health Clinics
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Map of RHCs in US
An interactive map that provides the name and location of Rural Health Clinics (RHCs) by state in the U.S.
Type: Map/Mapping System
Sponsoring organization: National Association of Rural Health Clinics
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CMS State Operations Manual (SOM)
Provides guidance to state agencies that survey healthcare facilities and providers to determine if they are in compliance with the Medicare Conditions of Participation (CoP). Includes appendices with regulatory information specific to Critical Access Hospitals (Appendix W), and Federally Qualified Health Centers/Rural Health Clinics (Appendix G). Can be used by healthcare facilities as a tool to self-evaluate their compliance with Medicare CoP.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicaid Benefits: Rural Health Clinic Services
Provides state-by-state information on Medicaid coverage of Rural Health Clinic (RHC) services. Includes populations covered, copayments, limitations, and reimbursement methodology.
Type: Website
Sponsoring organization: Kaiser Family Foundation
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ICD-10 Toolkit
Provides guidance and assistance to rural healthcare providers in making the transition from ICD-9 to ICD-10. This toolkit is designed to be used in conjunction with any coder or physician training that a rural hospital or clinic may be doing.
Type: Tool
Sponsoring organization: National Rural Health Resource Center
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Health Professional Shortage Area (HPSA) Application and Scoring Process
Provides Health Professional Shortage Area designations based on general HPSA designation criteria, plus additional criteria and guidelines specific to each of the three types of designations: primary care, dental and mental health.
Type: Website
Sponsoring organization: Health Resources and Services Administration
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Find Shortage Areas: HPSA & MUA/P by Address
Searchable tool for identifying Health Professional Shortage Areas (HPSAs), Medically Underserved Areas/Populations (MUA/P) by address.
Type: Website
Sponsoring organization: Health Resources and Services Administration
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Partners in Health: Mental Health, Primary Care and Substance Use Interagency Collaboration Tool Kit
Designed to help primary care clinics and behavioral health agencies, including FQHCs and RHCs, to build collaborative relationships. Provides job descriptions, sample agreements and contracts, screening instruments and evaluation measures, operational forms, strategies and prototypes for integrating mental and physical services, practical advice, issues to consider when brokering agreements, and mutual role descriptions.
Type: Document
Sponsoring organization: Integrated Behavioral Health Project
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Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Billing Guide
Describes the information FQHCs are required to submit for a Prospective Payment System (PPS), and it explains how RHCs should bill for certain preventive services under the Affordable Care Act.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Health Clinic: Rural Health Fact Sheet Series
Provides an overview of the Rural Health Clinic (RHC) program and services. Includes information regarding Medicare certification.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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RHC & FQHC Program Comparison
A chart that provides a comparison between the Rural Health Clinic (RHC) program and the Federally Qualified Health Center (FQHC) program.
Type: Document
Sponsoring organization: National Association of Rural Health Clinics
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Medicare Quarterly Provider Compliance Newsletter
A quarterly newsletter to help health care providers avoid common Medicare billing errors and comply appropriately with payment audits.
Type: Journal/Newsletter
Sponsoring organization: Centers for Medicare and Medicaid Services
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PubMed Search: Rural Health Clinics
Searches PubMed's collection of journal article citations with abstracts for items related to rural health clinics and published in the United States.
Type: Literature Search
Sponsoring organization: National Library of Medicine
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CMS Rural Health Clinics Center
Provides links to manuals, billing codes, enrollment and certification information, legislation, regulations, and contacts related to Medicare and Medicaid services in the rural health clinics.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Survey & Certification - Certification & Compliance: Rural Health Clinics
Provides basic information about being certified as a Medicare participating rural health clinic (RHC) with links to applicable laws, regulations, and compliance information.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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List of Medicare Certified Rural Health Clinics
Provides a list of all RHCs in each of the 50 states. Includes provider number, name, address, city-state-zip, phone number, and county.
Type: Directory
Sponsoring organization: Centers for Medicare and Medicaid Services
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Am I Rural?
Helps determine whether a specific location is considered rural based on various definitions of rural, including definitions that are used as eligibility criteria for federal programs. Definitions covered include Rural Urban Commuting Areas (RUCAs), Core Based Statistical Areas, Rural Urban Continuum Codes (RUCC), and Urban Influence Codes (UICs).
Type: Tool
Sponsoring organization: Rural Health Information Hub
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CMS Medicare Administrative Contractors
Provides information and resources concerning the Part A/Part B Medicare Administrative Contractors (MACs).
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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State Survey Agency Directory
Contains a directory of state agencies that handle survey and certification of certain health care facilities including Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) for compliance with the Medicare health and safety standards. Updated quarterly.
Type: Directory
Sponsoring organization: Centers for Medicare and Medicaid Services
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Developing and Implementing a Discount Fee Schedule
Basic information for clinics and health centers about developing and implementing a sliding fee schedule for low-income populations.
Type: Website
Sponsoring organization: National Health Service Corps
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Social Security Act, Section 1833 (f) and (h): Payment of Benefits
Payment limits for Rural Health Clinics and clinical laboratory services under the Social Security Act.
Type: Document
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MUA Find
Search for Medically Underserved Areas and Populations (MUAs/MUPs). Allows searching by state, county, or ID number. Includes designation status and date.
Type: Database
Sponsoring organization: Health Resources and Services Administration
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Rural Health Clinic - Rules and Guidelines
Interpretive guidelines for the Medicare regulations governing the Rural Health Clinic (RHC) program. Used by state surveyors to ensure that clinics are in compliance with the technical requirements of the RHC program.
Type: Document
Sponsoring organization: National Association of Rural Health Clinics
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Additional resources are available related to this guide. See the full list of resources by topic for:


Last Updated: 9/14/2017