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 on December 1st and March 1st. The December 1st report will include the rates effective January 1st of the upcoming year and the March 1st report will include any revisions to the report such as new or terminating facilities, changes to the rate, etc.
IRHCs are reimbursed by MO HealthNet on an interim basis at the Medicare RHC rate and cost settled on an annual cost report. This rate list contains the interim rates that MHD will reimburse IRHCs for services provided to MO HealthNet participants for the effective date noted on the report.
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.