Healthcare Insights
Most common rural health clinic procedures
Living in the big city comes with perks, and one of them is access to abundant healthcare services. The same can’t always be said for rural communities. Rural health clinics (RHCs) play a crucial role in providing healthcare to patients living in more rural areas, which are often lower-income and have limited access to local facilities and transportation to facilities in more urban areas.
What services are offered at rural health clinics?
Rural health clinics are outpatient care facilities that are typically staffed with nurse practitioners, physician assistants, and certified nurse midwives.
These clinics typically provide services relating to primary care or routine laboratory services. Additionally, rural health clinics are usually able to provide the first response to common life-threatening injuries or illnesses.
Definitive Healthcare tracks more than 5,000 active rural health clinics in the U.S. in the ClinicView product. Using the Atlas All-Payor Claims dataset, we looked at the top procedures performed at these clinics. The data below represents the most commonly performed procedures in RHCs in 2023 through October by percentage of total procedures performed at rural health clinics.
| Rank | HCPCS/CPT Code | HCPCS Description | Percent of total procedures | Explore dataset |
|---|---|---|---|---|
| 1 | 99213 | Office visit, established patient, 20-29 minutes | 17.30% | Explore |
| 2 | 99214 | Office visit, established patient, 30-39 minutes | 11.90% | Explore |
| 3 | T1015 | Clinic service | 6.90% | Explore |
| 4 | 36415 | Routine venipuncture | 2.40% | Explore |
| 5 | 96372 | Therapeutic, prophylactic, or diagnostic substance injection | 1.70% | Explore |
| 6 | 99212 | Office visit, established patient, 10-19 minutes | 1.60% | Explore |
| 7 | 87880 | Streptococcus immunoassay with optical | 1.40% | Explore |
| 8 | 87804 | Influenza immunoassay with optical | 1.00% | Explore |
| 9 | 90471 | Immunization administration | 1.00% | Explore |
| 10 | 99203 | Office visit, new patient, 30-44 minutes | 1.00% | Explore |
| 11 | G0439 | Annual wellness visit, personalized prevention plan, subsequent visit | 0.90% | Explore |
| 12 | 81003 | Urine analysis without scope | 0.80% | Explore |
| 13 | 99204 | Office visit, new patient, 45-59 minutes | 0.70% | Explore |
| 14 | 99215 | Office visit, established patient, 40-54 minutes | 0.70% | Explore |
| 15 | 99396 | Established well-patient visit, patient age 40-64 | 0.70% | Explore |
Fig. 1. Data is from the Atlas All-Payor Claims dataset. Data accessed November 2023.
What are the most common procedures at rural health clinics?
The most common procedure performed in rural health clinics is an office visit with an established patient ranging from 20 to 29 minutes. This procedure accounts for 17.3% of all procedures performed at rural health clinics. Though an office visit is not technically a procedure, it does have a designated Current Procedural Terminology (CPT) code used for claims purposes, which is why it is considered a procedure in this analysis.
Similarly, office visits with established patients ranging from 30 to 39 minutes rank as the second most common, accounting for 11.9% of all rural health clinic procedures.
Since office visits are typically the first step in the care journey for most patients, it’s unsurprising that these are the most commonly billed procedures, as patients typically see a provider for an office visit before receiving any sort of treatment or secondary care.
The third most common procedure at rural health clinics is clinic service. Accounting for 6.9% of all procedures, clinic service is an all-inclusive visit/encounter code, likely why it ranks high on the list of RHC procedures.
What is the difference between rural health clinics and federally qualified health centers?
While rural health clinics and federally qualified health centers (FQHCs) both provide healthcare services to low-income and underserved communities, they differ in the following ways:
- Rural health clinics only operate in rural areas, while FQHCs operate in both rural and urban areas.
- Rural health clinics do not charge patients on a sliding scale, while FQHCs do.
- Rural health clinics can be non-profit or for-profit. FQHCs can be non-profit or public.
- Rural health clinics provide care under a specialty (e.g., pediatrics), while FQHCs must provide care to all patient demographics with minimum service requirements.
Learn more
Healthcare Insights are developed with healthcare commercial intelligence from the Definitive Healthcare platform. Want even more insights? Explore the top 10 rural health clinics by total cost. Or start a free trial now and get access to the latest healthcare commercial intelligence on hospitals, physicians, and other healthcare providers.
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