2024 RHC/FQHC Payment Rates Published | Burrows Consulting

2024 RHC/FQHC Payment Rates Published

All-Inclusive Rate and Medicare Economic Index (MEI) G-code Rates

RHC 2024 Upper Payment Limits

• (Non-Grandfathered) Upper Payment Limit : $139.00

• (Grandfathered RHCs) MEI adjustment to Upper Payment Limit: 4.6% or $139.00 whichever is greater

• Grandfathered RHCs = Provider-Based RHCs owned by hospitals with less than 50 beds that were in operation on or had submitted their 855A by December 31, 2020

o Reimbursement corresponds to 3* distinct, qualifying services per day

o Costs associated with IOP services must be carved out of RHC cost report

• An IOP service and a separate mental health encounter would not be eligible for same day billing (RHC All Inclusive Rate reimbursement plus $284). However, RHCs could bill for IOP services and a separate medical visit for the same patient on the same day when appropriate.

 

Federally Qualified Health Center Prospective Payment System: CY 2024 Pricer

Based on data through June 2023, the CY 2024 Federally Qualified Health Center (FQHC) Prospective Payment System base payment rate is $195.99, which is 4.7% higher than 2023. Find your geographic adjustment factor (ZIP).

Please contact Melissa Jones, CRHCP, Rural Health Clinic Senior Associate, Burrows Consulting at melissa@burrowsconsulting.net with any questions.

 

Written By: Melissa Jones, CRHCP, Rural health Clinic Senior Associate at Burrows Consulting, LLC

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