Rural Health Clinics – Medicare Productivity Standard Exceptions

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The current productivity standards require 4,200 visits per full-time equivalent physician and 2,100 visits per full-time equivalent non-physician practitioner.  If actual visits are less than the productivity standards, the average cost per visit will be computed based on the productivity standards rather than actual visits, resulting in the cost per visit to be lower than if actual visits were used.

If you are having difficulty meeting productivity standards as a result of COVID-19 or any other justifiable reason, you may request an exception to the productivity standards.  The following information is required:

  • Visit count that you are requesting as an exception to the standards
  • Documentation to justify an exception to the standard

A separate request is required for each facility/clinic, and additional information may be requested by the MAC after receipt of the request.

If you have any questions or need assistance with requesting the exception, please contact Ben Glass in our Albany office at (229) 883-7878 or at bglass@draffin-tucker.com.