Maximum rate of payment per visit for independent rural health clinics

in 1988, after March 31, at $46 per visit, and

in a subsequent year (before April 1, 2021 ), at the limit established under this paragraph for the previous year increased by the percentage increase in the MEI (as defined in section 1395u(i)(3) of this title ) applicable to primary care services (as defined in section 1395u(i)(4) of this title ) furnished as of the first day of that year.

in 2021, after March 31, at $100 per visit;

in 2022, at $113 per visit;

in 2023, at $126 per visit;

in 2024, at $139 per visit;

in 2025, at $152 per visit;

in 2026, at $165 per visit;

in 2027, at $178 per visit;

in 2028, at $190 per visit; and

in a subsequent year, at the limit established under this paragraph for the previous year increased by the percentage increase in the MEI applicable to primary care services furnished as of the first day of such subsequent year.

In establishing limits under subsection (a) on payment for rural health clinic services furnished on or after April 1, 2021 , by a rural health clinic described in subparagraph (B), the Secretary shall establish such limit, with respect to each such rural health clinic, for services provided—

(i) in 2021, after March 31, at an amount equal to the greater of— (I) with respect to a rural health clinic that had a per visit payment amount established for services furnished in 2020— (aa) the per visit payment amount applicable to such rural health clinic for rural health clinic services furnished in 2020, increased by the percentage increase in the MEI applicable to primary care services furnished as of the first day of 2021; or (bb) the limit described in paragraph (2)(A); and (II) with respect to a rural health clinic that did not have a per visit payment amount established for services furnished in 2020— (aa) the per visit payment amount applicable to such rural health clinic for rural health clinic services furnished in 2021; or (bb) the limit described in paragraph (2)(A); and

(ii) in a subsequent year, at an amount equal to the greater of— (I) the amount established under subclause (I) or (II) of clause (i), as applicable, or this subclause for the previous year with respect to such rural health clinic, increased by the percentage increase in the MEI applicable to primary care services furnished as of the first day of such subsequent year; or (II) the limit established under paragraph (2) for such subsequent year.

in 2021, after March 31, at an amount equal to the greater of—

(I) with respect to a rural health clinic that had a per visit payment amount established for services furnished in 2020— (aa) the per visit payment amount applicable to such rural health clinic for rural health clinic services furnished in 2020, increased by the percentage increase in the MEI applicable to primary care services furnished as of the first day of 2021; or (bb) the limit described in paragraph (2)(A); and

(II) with respect to a rural health clinic that did not have a per visit payment amount established for services furnished in 2020— (aa) the per visit payment amount applicable to such rural health clinic for rural health clinic services furnished in 2021; or (bb) the limit described in paragraph (2)(A); and

with respect to a rural health clinic that had a per visit payment amount established for services furnished in 2020—

(aa) the per visit payment amount applicable to such rural health clinic for rural health clinic services furnished in 2020, increased by the percentage increase in the MEI applicable to primary care services furnished as of the first day of 2021; or

(bb) the limit described in paragraph (2)(A); and

the per visit payment amount applicable to such rural health clinic for rural health clinic services furnished in 2020, increased by the percentage increase in the MEI applicable to primary care services furnished as of the first day of 2021; or

the limit described in paragraph (2)(A); and

with respect to a rural health clinic that did not have a per visit payment amount established for services furnished in 2020—

(aa) the per visit payment amount applicable to such rural health clinic for rural health clinic services furnished in 2021; or

(bb) the limit described in paragraph (2)(A); and

the per visit payment amount applicable to such rural health clinic for rural health clinic services furnished in 2021; or

the limit described in paragraph (2)(A); and

in a subsequent year, at an amount equal to the greater of—

(I) the amount established under subclause (I) or (II) of clause (i), as applicable, or this subclause for the previous year with respect to such rural health clinic, increased by the percentage increase in the MEI applicable to primary care services furnished as of the first day of such subsequent year; or

(II) the limit established under paragraph (2) for such subsequent year.

the amount established under subclause (I) or (II) of clause (i), as applicable, or this subclause for the previous year with respect to such rural health clinic, increased by the percentage increase in the MEI applicable to primary care services furnished as of the first day of such subsequent year; or

the limit established under paragraph (2) for such subsequent year.

A rural health clinic described in this subparagraph is a rural health clinic that—

(i) as of December 31, 2020 , was in a hospital with less than 50 beds and after such date such hospital continues to have less than 50 beds (not taking into account any increase in the number of beds pursuant to a waiver under subsection (b)(1)(A) of section 1320b–5 of this title during the emergency period described in subsection (g)(1)(B) of such section); and

(ii) (I) as of December 31, 2020 , was enrolled under section 1395cc(j) of this title (including temporary enrollment during such emergency period for such emergency period); or (II) submitted an application for enrollment under section 1395cc(j) of this title (or a request for such a temporary enrollment for such emergency period) that was received not later than December 31, 2020 .

as of December 31, 2020 , was in a hospital with less than 50 beds and after such date such hospital continues to have less than 50 beds (not taking into account any increase in the number of beds pursuant to a waiver under subsection (b)(1)(A) of section 1320b–5 of this title during the emergency period described in subsection (g)(1)(B) of such section); and

(I) as of December 31, 2020 , was enrolled under section 1395cc(j) of this title (including temporary enrollment during such emergency period for such emergency period); or

(II) submitted an application for enrollment under section 1395cc(j) of this title (or a request for such a temporary enrollment for such emergency period) that was received not later than December 31, 2020 .

as of December 31, 2020 , was enrolled under section 1395cc(j) of this title (including temporary enrollment during such emergency period for such emergency period); or

submitted an application for enrollment under section 1395cc(j) of this title (or a request for such a temporary enrollment for such emergency period) that was received not later than December 31, 2020 .