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
