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December 2016 Texas Medicaid Provider Procedures Manual

Clinics and Other Outpatient Facility Services Handbook : 7 Rural Health Clinic : 7.2 Services, Benefits, Limitations, and Prior Authorization : 7.2.1 Services Rendered by the RHC Facility Provider : 7.2.1.1 Encounter Rates

7.2.1.1
An encounter rate may be reimbursed to the RHC facility only for the following services:
 
General medical services must be submitted using one of the appropriate modifiers AJ, AM, SA, TD, TE, or U7. Adult preventative care must be submitted with diagnosis codes Z0000, Z0001, Z01411, and Z01419.
Note:
If the encounter is for antepartum or postpartum care, use modifier TH in addition to the modifier required to clarify the service that was performed.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.