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With the implementation of the Outpatient Perspective Payment System (OPPS), can a hospital-based Rural Health Clinic (RHC) bill for RHC services and non- RHC services on the same claim?

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With the implementation of the Outpatient Perspective Payment System (OPPS), can a hospital-based Rural Health Clinic (RHC) bill for RHC services and non- RHC services on the same claim?

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Effective August 1, 2000, non-RHC services provided by a hospital-based RHC will be subject to payment under OPPS. As a result, hospital-based RHCs must discontinue billing non-RHC services on the RHC claims (type of bill 71X). Non-RHC services provided by the hospital-based RHC must be submitted utilizing the hospital bill type 13X or 14X under the hospital’s provider number. RHC services remain subject to the encounter rate payment methodology and will continue to be billed using the RHC provider number, RHC type of bill (71X) and revenue codes 52X and 81X.

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