Certified Revenue Cycle Representative (CRCR) Practice Exam

What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not billable as an RHC service?

1. Preventive care

2. Outpatient care

3. Inpatient care

4. Diagnostic services

The correct answer is: Inpatient care

In the context of services provided to Medicare beneficiaries, inpatient care is not billable as a service from a rural health clinic (RHC). RHCs are designed to provide outpatient services, which include preventive care, outpatient care, and diagnostic services. Inpatient care refers to services provided when a patient is admitted to a hospital and stays overnight or longer for treatment. RHCs are primarily structured to provide outpatient services to patients who do not require hospitalization and focus on preventive care, management of health concerns, and treatments that do not necessitate an overnight stay. As such, they do not have the facilities or the scope of services to bill for inpatient care under Medicare guidelines. The other options—preventive care, outpatient care, and diagnostic services—are integral components of what RHCs offer and can be billed, making them compliant with the billing requirements for these clinics.