Independent Rural Health Clinic Medicare/Medicaid Interim Rate List
The Independent Rural Health Clinic (IRHC) Medicaid Interim Rate List contains the interim rate per visit that the MO HealthNet Division (MHD) will reimburse IRHCs for services provided to MO HealthNet participants. IRHCs are reimbursed on an interim basis at the rate noted on this report and a final cost settlement is determined on the facility's annual cost report. MHD reimburses IRHCs on an interim basis at the Medicare Maximum Interim IRHC Rate, unless a provider requests a lower rate. The IRHC Rate List is updated at the beginning of each calendar year to reflect the new Medicare Maximum Rate effective January 1st and is updated if needed to reflect new or terminating facilities and rate changes.
This report is for informational purposes only and MHD is not responsible for how outside parties utilize the information. The general program policies governing the MO HealthNet IRHC program are set forth in 13 CSR 70-94.010 Independent Rural Health Clinic Program. 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.
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 are to reimburse IRHCs one hundred percent (100%) of the interim rate per visit noted in this report. For further information on managed care, please visit http://dss.mo.gov/mhd/mc/. If you have any questions regarding the managed care program for IRHCs, please contact (573) 526-4274.