Understanding Rural Health Clinic Services, Use, and Reimbursement

Research center:
Lead researcher:
Project funded:
September 2020
Anticipated completion date:
May 2024

This study will address the following research questions:

  1. What are the characteristics and intensity of the services (e.g. evaluation and management [E&M] services, other procedures) provided by Rural Health Clinics (RHCs)?
  2. Are there differences in the intensity and type of clinical services provided by various types of RHCs (i.e. provider-based versus independent) and across the rural continuum and/or census divisions/regions?
  3. What are the most common diagnoses for services provided to Medicare beneficiaries?
  4. What types of non-RHC services are RHCs billing to Medicare Part B (e.g. care management, telehealth, inpatient E&M services, other procedures)?
  5. How do estimated fee for service payments to RHCs under the Centers for Medicare and Medicaid Services' changes to the outpatient E&M codes in 2021 compare to the 2021 per-visit reimbursement cap?