Rural Health Clinics

Rural Health Clinic (RHC) services are a set of health care services, either core services or other ambulatory services, for Medicaid members. The Rural Health Clinic Services Act (PL95-210) authorizes 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.

Financial Information

• Fee Schedules
• Rural Health Clinics Cost Report - Hospital-based
• Rural Health Clinics/Federally Qualified Health Centers Cost Report - Freestanding

Core Billing Rates

To establish and maintain rates for RHC providers, the following documents must be submitted to NC Medicaid by mail or fax:

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

Coverage and Requirements

• Clinical Coverage Policy 1D-4, Core Services Provided in Federally Qualified Health Centers and Rural Health Clinics
• Best Methods for Successful Medicaid Enrollment

Change in Scope of Services

• Change in Scope of Service Policy
• CISS form for CMS222-92
• CISS form for CMS224-14
• CISS form instructions

Contact

Provider Reimbursement Team 
Phone: (984) 304 2260
Fax: (919) 831-1811
Email: Medicaid.ProviderReimbursement@dhhs.nc.gov

Mailing Address
2501 Mail Service Center
Raleigh NC 27699-2501

NC Medicaid Clinical Section
Phone: 919-855-4260
Fax: 919-733-2796