Congress Passes FY2023 Omnibus

Sarah Hohman, NARHC Director of Government Affairs


The Consolidated Appropriations Act of 2023, also known as the yearly “Omnibus” package which will fund the federal government for the remainder of Fiscal Year 2023 heads to President Biden’s desk to be signed into law today after passing both the Senate and the House.

Several provisions that we flagged for RHCs earlier this week remain in the final legislative text -

  • Expanded Medicare coverage to include Marriage and Family Therapists (MFTs) and Mental Health Counselors – read our full article here.
  • Waived 4% “pay as you go” or PAYGO Medicare reduction (for two years) which was previously set to kick in January 1, 2023.
  • Extended several Medicare telehealth provisions, including RHC G2025 policy through December 31, 2024, and delays in-person requirements for mental health services done via telehealth until January 1, 2025, as well. More details can be found here.
  • Created “intensive outpatient services” treatment category for which RHCs are eligible providers under a special payment rule. These treatment programs are intended for patients with needs less severe than would require residential programs but more involved care than typical office visits. We expect further details in the Medicare Physician Fee Schedule proposed rule next summer before this begins January 1, 2024.
  • Separates the Medicaid continuous eligibility policy from the PHE, allowing states to begin the so called “Medicaid redetermination” process as soon as April 2023. States will need to re-determine eligibility for all current beneficiaries. RHCs can visit our previous article on the topic for resources that can be used to educate your patients on the upcoming process to ensure they don’t unnecessarily lose coverage.
  • Provided $5 million in funding to establish an Office of Rural Health at the CDC.

Finally, we are disappointed to share that the grant funding for the RHC Behavioral Health Initiative, proposed in the President’s budget and included in draft appropriations report language, was struck from the text.

“This year’s omnibus package contains a mixed bag of provisions for rural health clinics” said Nathan Baugh, NARHC Executive Director. “Telehealth coverage is stabilized through 2024, but our current telehealth payment and coding policy remains flawed. Despite the late removal of the RHC-specific initiative for behavioral health, Congress did explicitly mention rural health clinics as eligible entities for two other grant opportunities. The legislation’s clear emphasis on improving mental health culminates with Medicare coverage of marriage and family therapists and mental health counselors and sets the stage for RHC-specific changes we are pursuing with the next Congress.”

More details will be coming in early 2023. Thank you for all you continue to do to serve your communities. Happy Holidays!

With any questions, please email Sarah Hohman at