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NC Department of Health and Human Services
NC Division of
Medical Assistance
 
 

Rural Health Clinics

DMA Clinical Policy and Programs
919-855-4260
Fax 919-733-2796

The Rural Health Clinic (RHC) Services Act (PL95-210) authorized Medicaid payments to certified rural health clinics for physician services and physician-directed services whether provided by a physician, physician's assistant, nurse practitioner, or certified nurse midwife.  The Rural Health Clinic Act established a set of health care services for which Medicaid recipients are entitled.  Medicaid RHC services are defined as either core services or other ambulatory services.

For core service requirements, coverage criteria, and limitations, refer to Clinical Coverage Policy 1D-4, Core Services Provided in Federally Qualified Health Centers and Rural Health Clinics.

For tips on enrollment as a RHC, refer to the February 2011 presentation on Best Methods for Successful Medicaid Enrollment (PDF, 214 KB).

Medicaid Bulletins

For changes and updates to coverage criteria, billing information, and other program requirements refer to the N.C. Medicaid general and special bulletins.

RHC Financial Information

Core Billing Rates

In order to establish and maintain rates for RHC providers, the following documentation must be submitted to N.C. Medicaid:

  • Enrollment letters from Centers for Medicare and Medicaid Services (CMS)
  • Enrollment letters from N.C. Medicaid Provider Enrollment
  • Both the initial and annually updated fiscal intermediary rate letters

Submissions may be by mail, fax or e-mail to

April High
DHHS-Division of Medical Assistance
Rate Setting Section
2501 Mail Service Center
Raleigh  NC  27699-2501
Phone: 919-814-0046
Fax: 919-814-0037
april.high@dhhs.nc.gov

Cost Reports

Fee Schedules

 

State of North Carolina Home Page
September 19, 2012