US · guidance
CMS Pub. 100-04, ch. 9, § 60
Billing Requirements for RHCs and FQHCs
RHCs and FQHCs are institutional claims and are submitted to the MAC on TOB 71X
and 77X. Generally, only those services that are included in the RHC and FQHC benefits
are billed on these claims.
• The RHC and FQHC benefits are defined in Pub. 100-02, Medicare Benefit
Policy Manual, Chapter 13
(http://www.cms.hhs.gov/manuals/Downloads/bp102c13.pdf.)
All professional services in the RHC and FQHC benefit are paid through the AIR system
or the FQHC PPS payment for each patient encounter or visit. Technical services (or
technical components of services with both professional and technical components) are
not billed on RHC/FQHC claims.
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
9c6a5da7544fe9486ea4e7ed55decba09521e1aff3be6d04a65bec721fc75f08
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