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RHC Upper Cost Rate Limited for 2017

| November 28, 2016
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Rural Health Clinics

Change Request (CR) 9829 provides MACs instructions for CY 2017 payment rate increases for RHCs. Section 1833(f) of the Social Security Act (the Act) authorizes that the payment limits for a subsequent year shall be increased in accordance with the rate of increase in the Medicare Economic Index (MEI). 

Based on historical data through second quarter 2016, the CY 2017 MEI is 1.2 percent. The RHC upper payment limit per visit for CY 2017 is $82.30, effective January 1, 2017, through December 31, 2017. The CY 2017 RHC rate reflects a 1.2 percent increase above the CY 2016 payment limit of $81.32. 

Your MAC will not retroactively adjust individual RHC bills paid at previous upper payment limits. However, MACs retain the discretion to make adjustments to the interim payment rate or a lump sum adjustment to total payments already made to take into account any excess or deficiency in payments to date. 
 

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