100-04 Medicare Claims Processing Manual: Chapter 9 Crosswalk

Medicare Claims Processing Manual
Chapter 9 - Rural Health Clinics / Federally Qualified Health Centers
Crosswalk
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9 	10 	A3-3642 	General Differences Between RHCs and FQHCs
9 	10 	A3-3643 	General Differences Between RHCs and FQHCs
9 	10.1 	A3-3642B 	B3-9200 	Rural Health Clinics (RHCs)
9 	10.2 	A3-3643 	RHC-400B 	Federally Qualified Health Centers
9 	10.3 	A3-3642 	B3-9200.1 	Claims Processing Jurisdiction for RHCs and Federally
Qualified Health Centers (FQHCs)
9 	20 	A3-3642 	RHC-500 	Method of Medicare Payment for RHC’s and Federally
Qualified Health Center (FQHC) Services
9 	20 	A3-3643 	RHC-504 	Method of Medicare Payment for RHC’s and Federally
Qualified Health Center (FQHC) Services
9 	20.1 	A3-3642B 	Payment Rate for Independent and Provider Based RHCs
and FQHCs
9 	20.2 	RHC-500 	A-99-10 	Calculation of the Encounter "Per Visit" Rate
9 	20.3 	RHC-500 	Calculation of Payment
9 	20.4 	RHC-500 	Determination of Payment

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9 	20.5 	RHC-500 	Annual Reconciliation
9 	20.6 	RHC-505 	Maximum Payment Per Visit
9 	20.6.1 	A-99-08 	Rural Health Clinics
9 	20.6.1 	A-00-30 	Rural Health Clinics
9 	20.6.2 	RHC-500 	Federally Qualified Health Centers
9 	20.6.3 	RHC-505 	Exceptions to Maximum Payment Limit (Cap) in
Encounter Payment Rate for Provider-Based RHCs
9 	20.7 	RHC-505.3 	Special Rules for FQHC Networks
9 	20.7.1 	RHC-505.3A 	Separate Payment Limits for Individual Cost Reports
9 	20.7.2 	RHC-505.3B 	Consolidated Payment Limit For Networks Having
Mixture of Urban and Rural Sites
9 	20.7.3 	RHC-505.3C 	Consolidated Payment Limit for FQHC Networks With All
Urban or All Rural Sites
9 	30 	RHC-506 	Annual Reconciliation with Cost Report
9 	30.1 	RHC-506 	Submission of Cost Report
9 	30.2 	RHC-506.1 	Payment Reconciliation
9 	30.3 	RHC-506.2 	Notice of Program Reimbursement
9 	30.4 	RHC-506.3 	Recovery of Overpayments

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9 	30.5 	RHC-507 	Reporting Requirements for Cost Report
9 	30.5.1 	RHC-507B 	Definitions
9 	30.6 	RHC-508 	When to Submit Cost Reports
9 	30.7 	RHC-508C 	Penalty for Failure to File Cost Reports Timely
9 	30.8 	RHC-508D 	Consolidated Cost Reports
9 	40 	RHC-501 	Allowable Costs
9 	40.1 	RHC-501.1 	Costs Excluded from Allowable Costs
9 	40.2 	RHC-502 	Allowable Costs Subject to Tests of Reasonableness
9 	40.3 	RHC-503 	Screening Guidelines of RHC/FQHC Health Care Staff
Productivity
9 	40.4 	A3-3628 	RHC-504 	All Inclusive Rate of Payment
9 	40.5 	RHC-504.1A 	Bad Debts
9 	40.6 	RHC-500B 	Calculation of Medicare Program Payment
9 	40.7 	RHC-500C 	Determination of Payments
9 	50 	RHC-504.1 	Deductible and Coinsurance
9 	50.1 	RHC-500B 	Part B Deductible
9 	50.2 	RHC-500B 	Part B Coinsurance

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9 	60 	A3-3185 	RHC-612 	Mental Health Services Limit
9 	60.1 	RHC-419.2E 	Definition of Mental Health Services in RHC/FQHC
9 	60.2 	A3-3185.1 	RHC-613 	Application of Limit
9 	70 	RHC-608 	Determining How Much to Charge Patient Before Billing
Is Submitted for Part B Payment
9 	100 	RHC-620 	General Billing Requirements
9 	110 	RHC-621 	Reporting of Preventive Services by Independent FQHCs
9 	120 	RHC-614 	Billing Requirements for Pneumococcal Pneumonia,
Influenza Virus, and Hepatitis B Vaccines
9 	130 	A-99-8 	Laboratory Services
9 	140 	B3-9204D 	Intermediary/Carrier Coordination
9 	140.1 	B3-9204D 	Intermediary Responsibility for Notifying Carrier
9 	140.2 	B3-9204 	Special Carrier Actions Relating to RHCs/FQHCs
9 	200 	RHC-310 	Agreements Between CMS and RHC/FQHC
9 	200.1 	RHC-310 	General
9 	200.2 	RHC-311 	Duration of RHC/FQHC Agreement
9 	200.3 	RHC-313 	Appeals by Entities With Respect to Agreements
(Certification)

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9 	210 	RHC-320 	Content and Terms of Agreements
9 	210.1 	RHC-321 	Charges to Beneficiaries
9 	210.2 	RHC-322 	Refunds to Beneficiaries
9 	210.3 	RHC-323 	Treatment of Beneficiaries
9 	220 	RHC-330 	Termination of Agreement
9 	220.1 	RHC-330 	Termination of Agreement by Clinic or Center
9 	220.2 	RHC-331 	Termination by CMS
9 	220.3 	RHC-332 	Effect of Termination
9 	220.4 	RHC-333 	Notice to the Public
9 	220.5 	RHC-334 	Conditions for Reinstatement of Clinic or Center
Terminated by CMS