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CMS Corrects Rural 2011 Pay Rates

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  • January 3, 2011
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Rural health clinics (RHCs) and federally qualified health centers (FQHCs) will see a slightly greater increase in 2011 payments than previously stated. The Centers for Medicare & Medicaid Services (CMS) recently corrected 2011 RHC and FQHC payment rates to reflect the 0.4 percent Medicare Economic Index (MEI) update published in the Physician Fee Schedule (PFS) final rule, rather than the 0.3 percent MEI update, published in the PFS proposed rule.
Effective Jan. 1, 2011 to Dec. 31, 2011:

  • The RHC upper payment limit per visit is increased from $77.76 to $78.07.
  • The FQHC upper payment limit per visit is increased from $125.72 to $126.22.
  • The maximum Medicare payment limit per visit for rural FQHCs is increased from $108.81 to $109.24.

Contractors are not required to retroactively adjust individual RHC/FQHC bills paid at previous upper payment limits but may 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.
For the official instruction, see CMS Transmittal 2123, dated Dec. 21, 2010, which rescinds and replaces Transmittal 2063, dated Oct. 8, 2010.

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