How are Rural Health Centers (RHCs) reimbursed under WHP?
RHCs are reimbursed for services under the prospective payment system as they are for family planning services under Medicaid. Procedure codes 99204, 99214, J7300, J7302, and J7307 are the only allowable codes for RHCs. Family planning services provided by an RHC are reimbursed when billed using a physician, physician assistant, or nurse practitioner’s provider identifier. Alternatively, an RHC can apply for enrollment as a family planning agency and bill using the family planning agency’s provider identifier. Services must be billed using modifiers AJ, AM, SA, or U7. These services must also be billed with the appropriate national place of service (72) for an RHC setting.
