US · guidance
CMS Pub. 100-02, ch. 13, § 220.2
Copayment and Deductible for RHC Preventive Health Services
When one or more qualified preventive service is provided as part of an RHC visit,
charges for these services must be deducted from the total charge for purposes of
calculating beneficiary copayment and deductible. For example, if the total charge for
the visit is $150, and $50 of that is for a qualified preventive service, the beneficiary
copayment and deductible is based on $100 of the total charge, and Medicare would pay
80 percent of the $100, and 100 percent of the $50 (minus any deductible). If no other
RHC service took place along with the preventive service, there would be no copayment
or deductible applied, and Medicare would pay 100 percent of the payment amount.
History
(Rev. 239, Issued: 01-09-18, Effective: 1-22-18, Implementation: 1-22-18)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
ac233e90e6ab98a85c0042ad9d7ad8adadb15a2f88dc41bddb367053131a7002
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