Arizona Rural Health Clinic Designation Manual - Arizona Center for ...

I. An Introduction to Rural Health Clinics
A. Background Information
What is a certified Rural Health Clinic
Rural Health Clinics (RHCs) provide primary healthcare services in medically underserved areas
and are certified under Medicare. Rural Health Clinics also receive an enhanced reimbursement
rate from Medicare and Medicaid.
What is required to be certified as a Rural Health Clinic
To be certified as a Rural Health Clinic (RHC), a clinic must:
• Be located in a non-urbanized area as determined by the U.S. Bureau of the Census;
• Be located in a federally designated Medically Underserved Area (MUA), a federally
designated Health Professional Shortage Area (HPSA), or in an area designated as
underserved by the state’s Governor;
• Provide outpatient primary care services and basic laboratory services;
• Employ at least one midlevel practitioner (Nurse Practitioner, Certified Nurse Midwife,
or Physician Assistant) who is on-site and available to see patients at least 50 percent of
the time the clinic is open;
• Meet health and safety requirements imposed by Medicare and Medicaid;
• Must have a physician on staff who provides medical supervision, direction, and consultation;
the physician must be present on-site at least one day every two weeks and avail
able by telecommunication for assistance at all times.
Clinic Ownership:
Clinic ownership can be private, non-profit, or public.
Provider-Based vs. Independent Rural Health Clinics:
• Provider-based Rural Health Clinics are owned and operated by any entity defined by the
Medicare statute as a “provider” (hospital, home health agency, or skilled nursing facility).
The reimbursement for Provider-based RHCs is handled by the provider associated with the RHC.
Provider-based Rural Health Clinics that are owned by a hospital with less than 50 beds are exempt
from the per-visit reimbursement cap. The criteria for a facility being defined as “Provider-based”
are not specific to the RHC program and apply to any department that seeks to be designated as
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