Rural Health Clinic (RHC) Medicare Coverage

Rural health clinics were created by federal law to address shortages of doctors and other health care professionals serving Medicare beneficiaries in rural areas.

RHCs were created by the Rural Health Clinic Service Act of 1977, and in addition to improving access to physicians in rural areas, it increased the number of nurse practitioners, physician assistants and certified nurse-midwives in rural areas served by RHCs.

Rural health clinics typically provide outpatient primary health care and preventive health services.

Medicare beneficiaries can use local rural health clinics and Medicare will reimburse the RHC for Medicare-approved costs. But you may still have out-of-pocket costs.

Your Medicare Part B deductible — $257 in 2025 — applies for most RHC visits. Services that Medicare does not cover do not count toward your deductible.

Once you’ve hit your deductible, Medicare pays 80 percent of the Medicare-approved costs.

But the deductible and coinsurance are waived on certain preventive services, including the initial preventive physical examination and annual wellness visit. Medicare pays 100 percent of preventive services’ costs.

Medicare pays RHCs an all-inclusive rate (AIR) for face-to-face primary health care Medicare considers “medically necessary.” The AIR also covers qualified preventive health services provided by one of the RHC’s health practitioners.

To qualify as an RHC, a clinic has to meet certain requirements and be certified by Medicare.

RHCs must be in a nonurbanized area as defined by the U.S. Census Bureau and in an area currently designated under federal law as one of four types of places that have limited access to health care in the previous four years.

The Department of Health and Human Services and the National Organization of State Offices of Rural Health maintain searchable databases and contact information to help you find a rural health clinic in your area.

Rural health clinics can be public, nonprofit or for-profit health care facilities. But to receive certification, they must be in underserved, rural areas and must use a team approach of doctors and nonphysician health care professionals working together to provide services.

All rural health clinics must have at least one nurse practitioner (NP) or physician assistant (PA) on staff. They must have either an NP, PA or a certified nurse-midwife (CNM) on-site at least 50 percent of the time the clinic is open.

In addition, a physician must supervise each NP, PA or CNM as required by the law of the state where the rural health clinic is located.