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Modifier - as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbur...

2012 - Payment Rate Increases for Medicare Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC)


Rural Health Clinic (RHC)


The RHC upper payment limit per visit is increased from $78.07 to $78.54 effective January 1, 2012, through December 31, 2012 (i.e., CY 2012). The 2012 rate reflects a 0.6 percent increase over the 2011 payment limit in accordance with the rate of increase in the Medicare Economic Index (MEI) as authorized by §1833(f) of the Social Security Act.

Federally Qualified Health Center (FQHC)

The FQHC upper payment limit per visit for urban FQHCs is increased from $126.22 to $126.98 effective January 1, 2012, through December 31, 2012 (i.e., CY 2012), and the maximum Medicare payment limit per visit for rural FQHCs is increased from $109.24 to $109.90 effective January 1, 2012, through December 31, 2012 (i.e. CY 2012). The 2012 FQHC rates reflect a 0.6 percent increase over the 2011 rates in accordance with the rate of increase in the MEI.

Reference: http://www.cms.gov/Transmittals/downloads/R2406CP.pdf

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