US · guidance
CMS Pub. 100-04, ch. 9, § 20.2
Payment Limit under the AIR
For RHCs that bill under the AIR, Medicare pays 80 percent of the RHC AIR, subject to
a payment limit. At the end of the cost reporting period, the MAC determines the total
payment due and reconciles payments made during the period with the total payments
due.
RHCs that receive payments under the AIR must submit an annual cost report to establish
their payment rate. If a RHC is in its initial reporting period, the MAC calculates an
interim rate based on a percentage of the per-visit limit, which is then adjusted when the
cost report is filed.
For information on cost reporting requirements, see the Medicare Provider
Reimbursement Manual (PRM), at http://www.cms.gov/Regulations-and-
Guidance/Guidance/Manuals/Paper-Based-Manuals.html
History
(Rev. 13264, Issued:06-09-25; Effective: 06-02-25; Implementation: 06-02-25)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
4b1d7f3b79ddbbb55fb2275d53ec7020c50f0a0f120cd2db586aff7a5922c7c6
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