Medicare-Designated Rural Health Clinics

A Rural Health Clinic (RHC) is a clinic certified to receive special Medicare and Medicaid reimbursement. The purpose of the RHC program is improving access to primary care in underserved rural areas.

Designated Rural Health Clinics are reimbursed based on a reasonable cost formula for Medicare visits, and on a modified cost-based formula or prospective payment for Medicaid visits. Many rural providers find that their reimbursement is significantly enhanced under this system.

Learn more about Rural Health Clinics:

  1. Rural Location Definition
  2. RHC Requirements
  3. Becoming an RHC

Rural Location Definition

Rural Health Clinics must be located in rural areas with current health care shortage designations.

Not in an Urbanized Area

Any area that is not in a U.S. Census-designated "urbanized area" is considered rural. To see if your location is in a rural area you can use the to Rural Health Information Hub's Am I Rural?.

Shortage Areas

Eligible clinics must be in a rural area designated or updated within the last four years by the U.S. Health Resources and Services Administration. There are four types of shortage areas that qualify:

  • Geographic-based HPSA (Health Professional Shortage Area)
  • Population-based HPSA
  • MUAs (Medically Underserved Area)
  • Governor Designated medically underserved area

To see if your location is in a federally designated Health Professional Shortage Area or Governor-Designated medically Underserved Area go to the Health Workforce website.

Rural Health Clinic Certification

The final determination of eligibility is made by your state agency responsible for RHC certification and the CMS regional office. For information on RHC eligibility, contact KDHE´s Bureau of Community Health Systems at 785-296-1200.