CMS Releases Guidance on Preventive Vaccine Billing for RHCs! Starting July 1, 2025Rural Health Clinics (RHCs) will be able to bill for all four Medicare Part B preventive vaccines and their administration at the time of service! Covered vaccines include:✔ Pneumococcal✔ Influenza✔ Hepatitis B✔ COVID-19 This is a big step forward in streamlining access and…

New Reporting Opportunity for RHCs! Beginning April 7, 2025, Rural Health Clinics (RHCs) can submit CPT Category II codes. These supplemental tracking codes support performance measurement and make it easier for RHCs to report data as part of value-based care models. While optional, using Category II codes can help streamline quality reporting and highlight the…

Great news for Rural Health Clinics (RHCs)! Congress has passed a funding bill that extends Medicare Telehealth flexibilities—including for Primary Care visits in RHCs—through September 30, 2025. 🔹 RHCs can continue to bill G2025 for telehealth services🔹 In-person requirements for mental health telehealth visits are delayed🔹 Patients can still access care from home or other…

Are you billing G0511 for Care Coordination Services? You may be leaving money on the table!👉 Click here for 2025 Codes and Payment Rates Want to learn more about Care Coordination billing opportunities?✔ Check out additional guidance on Care Coordination Make sure your clinic is capturing all eligible revenue!

Big News for Rural Health Clinics (RHCs)! Effective January 1, 2025, CMS is removing the 51% threshold requirement that previously measured the proportion of Primary Care services delivered by RHCs. While this threshold is going away, RHCs must still provide Primary Care Services and cannot operate as a Rehabilitation Agency or as an entity primarily…

Simplified Medicare Credit Balance Reporting for Providers Starting December 2024, providers will no longer need to report Medicare credit balances quarterly. Instead, reporting is now only required when an actual overpayment is identified. This change reduces administrative burden and allows providers to:✅ Eliminate unnecessary paperwork✅ Focus efforts on meaningful compliance✅ Streamline internal processes This is…

What does the extension mean?Rural Health Clinics can continue to serve as a telehealth distant site, billing G2025 until March 31, 2025.The occasional in-person visit for mental health telehealth visits is waived.Medicare geographic and originating site flexibility will continue. Read more from NARHC below!NARHC Article

Rural Health Care Clinics have been required to perform 6 laboratory tests since the Rural Health Clinic Services Act was created in 1977.GlucosePregnancy TestPrimary Culturing for TransmittalChemical Examination of Urine by Stick or TabletHemoccultHemoglobin or Hematocrit The Centers for Medicare and Medicare Services (CMS) recently released the 2025 Medicare Physician Fee Schedule Final Rule. One…

CMS has updated the Rural Health Clinic (RHC) all-inclusive rate (AIR) for CY 2025. The RHC payment limit per visit for Independent and Provider-Based RHCs in hospitals with 50 or more beds is $152.00. Grandfathered RHCs established payment limit is an amount equal to the greater of:RHC payment limit per visit beginning January 1, 2024, increased…

The Beyond-Use Date (BUD) refers to the date after which an opened multi-dose vial should not be used. Multi-dose vials typically contain an antimicrobial preservative to help prevent the growth of bacteria. Thus, if used after 28 days (BUD), it risks the effectiveness.  A multi-dose vial BUD should never exceed the manufacturer’s expiration date on…