The Centers for Medicare & Medicaid Services (CMS) updated the Rural Health Clinic (RHC) all-inclusive rate for calendar year (CY) 2025. The payment limit per visit for independent and provider-based RHCs in hospitals with 50 or more beds is $152.00. The payment limit per visit for specified provider-based RHCs, with an April 1, 2021 established payment limit, that continue to meet the qualifications in section 1833(f)(3)(B) of the Social Security Act is the greater of these amounts: 1) Your payment limit per visit starting January 1, 2024, increased by 3.5 percent; 2) The national statutory CY 2025 payment limit per visit of $152.00. For more information see the Medicare Claims Processing Manual, Chapter 9, section 20.2 and Instruction to your Medicare Administrative Contractor.
