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US · guidance

CMS Pub. 100-04, ch. 12, § 90.4.9

HPSA Incentive Payments for Physician Services Rendered in a

activein force · 2026-08-25 – presentas-observed

Critical Access Hospital (CAH)

(Rev. 608, Issued: 07-22-05; Effective: 01-01-06; Implementation: 01-03-06)

If a CAH electing the Optional Method (Method II) is located within a mental health

HPSA, the psychiatrists providing (outpatient) professional services in the CAH are

eligible for the Mental Health and Primary Care HPSA bonus payments. When billing

for this service, the CAH must bill using Revenue code 961 plus the applicable HCPCS.

This Mental Health HPSA bonus will be paid to the CAH on a quarterly basis by the FI.

If an area is designated as both a mental health HPSA and a primary medical HPSA, only

one 10% bonus will be paid for the service.

Refer to §250.2 in the Claims Processing Manual, Chapter 4 for additional information.

History

(Rev. 608, Issued: 07-22-05; Effective: 01-01-06; Implementation: 01-03-06)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
ee795eb106c01e7b537e6d51c4e2ca6c27408d821ae2837678306845a45fc1e6
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