Master Medicare Rules for Rural Health Clinics


As part of the 2024 Rural Health Workshop, Well-Ahead Louisiana and the Louisiana Rural Health Association are hosting a free Medicare Boot Camp®–Rural Health Clinic Version, presented by HCPro.

The Medicare Boot Camp®–Rural Health Clinic Version is a one-day intensive course on Medicare designation, coding, billing, and payment for rural health clinics. This training will give you the knowledge and tools to find the answers to your most compelling Medicare billing questions pertaining to this unique setting. 

This in-depth training will cover a wide range of Medicare requirements to ensure you are able to successfully process claims and get paid without disruption to your revenue stream. View the agenda for more information.

The event will be held on June 10, 2024, from 8:00 a.m. to 4:30 p.m. as a pre-conference to the 2024 Rural Health Workshop at the Renaissance Hotel in Baton Rouge. Lunch will be provided, and attendance is free. The event is limited to 50 attendees.  Due to limited space, only one individual from an organization may register at this time.

Registration is now closed for the Medicare Boot Camp®–Rural Health Clinic Version.

The Medicare Boot Camp®–Rural Health Clinic Version has been approved for 4.0 hours of CRHCP Continuing Education Units and 7.5 hours of AHIMA credits.

Register for the Medicare Boot Camp®–Rural Health Clinic Version


  • Module 1: Designation as a Rural Health Clinic, including Required Practitioners and Services
    • Definition and purpose of an RHC
    • Certification criteria, including location, staffing, and required services
    • Basic requirements for services furnished by RHC practitioners or incident to an RHCpractitioner, including requirements for direct supervision
    • Services that are excluded from the RHC benefit
    • Distinguish between an independent and provider-based RHC
  • Module 2: Medicare Claims Fundamentals
    • Claims processing requirements, including type of bill, revenue codes, HCPCS codes,modifiers, and charge reporting
    • RHC practitioners and Appropriate Use Criteria (AUC)
    • Three day window applicability
  • Module 3: The Qualifying Visit and Related Services
    • Qualifying visit definition
    • Coding and charging for the qualifying visit, including proper use of modifier -CG
    • Mental health qualifying visits by telecommunication technology
    • Preventative services provided with or as a qualifying visit, including vaccines
    • Incident to services, including drugs and drug administration services
    • Global Surgery Concepts for RHCs
  • Module 4: Special RHC Billing Issues
    • Transitional Care Management (TCM)
    • General Care Management (GCM), including Chronic Care Management (CCM),Principal Care Management (PCM) and General Behavioral Health Integration (BHI)services
    • Psychiatric Collaborative Care Model (CoCM)
    • Telehealth, including originating and distant site services
    • Virtual Communication Services
    • Services for hospice patients
    • Visiting Nurse services
    • Laboratory services and technical components of diagnostic services
  • Module 5: Reimbursement for Rural Health Clinic Services
    • Identification of a qualifying visit for payment purposes
    • Basic all-inclusive rate reimbursement methodology for provider-based andindependent RHCs
    • Application of upper payment limit
    • Application of Part B deductible and coinsurance
  • Module 6: Supplemental Review of Medicare Contractors, Research, and Resources
    • Overview of Medicare Parts A, B, C, and D
    • Role of Medicare contractors
    • Medicare source laws, including statutes and regulations
    • Medicare sub-regulatory guidance, including manuals and transmittals
    • Links to Medicare information and resources for staying current
  • Module 7: Supplemental Review of Medicare Coverage Guidance and the Advance Beneficiary Notice
    • Medicare Coverage Center, including NCDs, LCDs, and Laboratory Manual
    • Coverage of drugs, including self-administered drugs
    • Limitations of liability statute and notice requirements
    • Advance Beneficiary Notice (ABN) and instructions
  • Module 8: Appendices of Source Authority
    • Regulations for Conditions for Certification (CfC) for RHC
    • Regulations with requirements for provider-based departments
    • Regulations defining RHC services and payment
    • Medicare Benefit Policy Manual, Chapter 13 for RHCs
    • Medicare Claims Processing Manual, Chapter 9 for RHCs
    • Medicare State Operations Manual, Appendix G, RHC CfC survey standards
    • RHC MLN Booklet
    • Integrated Outpatient Code Editor, RHC excerpts
    • RHC Flexibilities During the COVID PHE, Updated for Post-PHE

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