Cost Report Visit Count Checklist

Cost Report Visit Count Checklist

RHC "visits" are defined by Medicare as a face to face encounter between the patient and a physician, physician assistant, nurse practitioner, nurse midwife, specialized nurse practitioner, clinical psychologist, or clinical social worker during which an RHC/FQHC service is rendered by the appropriate professional. (scope of practice).

Type of Service	Count as a Visit for Cost Report	Visit Count

Office Visit	Yes

Hospital Visit/Emergency Room/Obs	No

Home Visit If the home visit occurs outside the RHC hours *and* you exclude the cost of the service on the cost report you may bill as follows: If the home visit cost is included in RHC cost report as an allowable cost, the visit is a RHC visit (doesn’t matter when the visit occurs)	No Yes
Hospital Swing-Bed (SNF)	Yes[1]

Skilled Nursing Home Visits (SNF)	Yes[2]

NF (Level) 1 - Nursing Home Visit	Yes

Welcome to Medicare Physicals	Yes

Physicals (Not Welcome to Medicare)	Yes[3]

EPSDT/Well Baby Visits	Yes[4]

Nurse Only Visits (99211)	No

No Charge/Sliding Fee Schedule	Yes

Home Care Oversight	No

[1] If you elect to exclude all Swing-bed visits and exclude all the costs from the cost report and bill the service to the Part B Carrier; do not count the visits.

[2] If you elect to exclude all Skilled Nursing visits and exclude all the costs from the cost report and bill the service to the Part B Carrier; do not count the visits.

[3] Riverbend GBA’s FAQ indicates that these Non-covered Medicare services should be included in the total visit counts; however, for some states such as North Carolina require that the RHC not count the visits and reclassify the expense to a non-allowable cost center. (if you want to prepare the State Cost Report correctly).