Independent Rural Health Clinic Medicare/Medicaid Interim Rate List

The Independent Rural Health Clinic (IRHC) Medicare/Medicaid Interim Rate List contains various information on IRHCs participating in the MO HealthNet program.  The information contained in this report is current as of the date indicated on the report and is true and accurate to the best of the MO HealthNet Division's (MHD) knowledge.  This report is updated semi-annually on April 1st and October 1st. 

IRHCs are reimbursed by MO HealthNet at the Medicare RHC rate.  This report contains the interim rates that are in MHD's Medicaid Management Information System (MMIS) and that MHD is reimbursing IRHCs for services provided to MO HealthNet participants as of the date of the report.  The interim rate may not be the most recent rate issued for Medicare but it is the most recent rate provided to MHD by the IRHC and is effective as of the date of service noted in the "Effective Date of Interim Rate" column.

This report is for informational purposes only and MHD is not responsible for how outside parties utilize the information.  Anyone using this report should be aware of the general program policies.  The policies and procedures governing the MO HealthNet IRHC program, including the reimbursement methodology, cost reporting requirements, etc. is set forth in 13 CSR 70-94.010 Independent Rural Health Clinic Program

IRHCs that are contracted with a health plan to provide managed care services to MO HealthNet participants.  According to the terms of the Managed Care Health Plan Contract, health plans shall reimburse IRHCs ninety percent (90%) of their Medicare/Medicaid interim rate per visit. For further information on the managed care contract, please visit http://dss.mo.gov/mhd/mc/.

If you have any questions regarding this report or the MO HealthNet IRHC program, please contact the Clinic Policy & Reimbursement Manager of the Institutional Reimbursement Unit at (573) 751-5663.

If you have any questions regarding the managed care program for IRHCs, please contact (573) 526-4274.