Definition: Rural Health Clinics (RHCs) is a specific designation from the Centers for Medicare and Medicaid Services (CMS). To receive this designation, the clinic has to increase access to primary care services for patients in rural underserved communities.
RHCs can be public, nonprofit, or for-profit health care facilities. RHCs are required to use a team approach of physicians working with non-physician providers such as nurse practitioners (NPs), physician assistants (PAs), and certified nurse midwives (CNMs) to provide services.1
How it relates to quality-based care, care of underserved patients, and pharmacists in these settings: Clinics that receive RHC status can collect higher reimbursement rates for government-funded individuals (including Medicare and Medicaid services).1 RHCs are eligible to apply and receive patient-centered medical home (PCMH) designation. There are currently no existing federal financial incentives or benefits that specifically encourage this.1 However, some state Medicaid programs do offer incentives for attaining PCMH status. RHCs are able to participate in the Medicare Shared Savings program and become an Accountable Care Organization (ACO) or join an existing ACO. ACOs create incentives for healthcare providers to coordinate care across various settings.
Pharmacists work in RHCs across the country. Unlike FQHCs, RHCs are not required to provide pharmacy services, but many RHCs do. In RHCs, pharmacists can directly be involved in patient care by dispensing medications and providing a variety of other patient care services, including medication management and immunizations. In those facilities where pharmacy services are externalized, pharmacists may be involved in various quality-based care initiatives, such as quality improvement initiatives, manage complex 340B formularies, and/or connect patients to affordable local pharmacies.
Involved organizations/oversight: To be certified as an RHC, clinics must meet location guidelines designated by the U.S. Census Bureau and the Health Resources and Services Administration (HRSA).2 RHCs must also adhere to applicable state and federal regulations, including Medicaid guidelines overseen by the individual states and Medicare rules and regulations set forth by CMS.3
Resources
- Rural Health Information Hub. Rural Health Clinics (RHCs). Grand Forks, ND: Rural Health Information Hub. Available at: https://www.ruralhealthinfo.org/topics/rural-health-clinics. Accessed June 11, 2025.
- CMS. Rural Health Clinic. Baltimore: CMS. Available at: https://www.cms.gov/files/document/mln006398-information-rural-health-clinics.pdf. Accessed June 11, 2025.
- CMS. Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) services. In: CMS. Medicare Benefit Policy Manual. CMS; 2025.
Contributing authors:
Emily Kosirog, PharmD, BCACP
Director of Clinical Pharmacy
Salud Family Health Centers
Fort Lupton, CO
Morgan Stewart, PharmD, BCACP, BC-ADM
Clinical Assistant Professor
University of Texas at Austin College of Pharmacy
Marsha Gilbreath, PharmD
Staff Pharmacist
Ascension Rx, Ascension St. Vincent’s Blount
Last Updated 6/11/25 by Ashley Daffron, PharmD, BCACP