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Rural Health Information Hub

Rural Health
Resources by Topic: Medicare

Medicare Part D Opioid Prescribing Mapping Tool
Interactive mapping tool identifies opioid prescription rates at the state, county, and zip code level for de-identified Medicare Part D claims in 2022. Also offers rural/urban opioid prescribing data, changes in prescribing rates in 1 year and 5 year increments, and hot spots and outliers in long-acting opioid prescribing.
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS State Operations Manual (SOM)
Provides guidance to state agencies that survey healthcare facilities and providers to determine if they are in compliance with the Medicare Conditions of Participation (CoP). Includes appendices with regulatory information specific to Critical Access Hospitals (Appendix W) and Federally Qualified Health Centers/Rural Health Clinics (Appendix G). Can be used by healthcare facilities as a tool to self-evaluate their compliance with Medicare CoP.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Code of Federal Regulations: Title 42 Public Health, Chapter 4, Subchapter G, Part 491, Subpart A - Rural Health Clinics: Conditions for Certification; and FQHCs Conditions for Coverage
Establishes the conditions Rural Health Clinics and Federally Qualified Health Centers must meet to qualify for reimbursement under Medicare, as well as those that Rural Health Clinics must meet to qualify for reimbursement under Medicaid.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Frontier Extended Stay Clinics (FESC) Demonstration
An overview of a completed CMS demonstration that looked at an enhanced clinic model in frontier areas to address the needs of seriously ill or injured patients who cannot be transferred to a hospital, or who need monitoring and observation for a limited period of time.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Frontier Community Health Integration Project Demonstration (FCHIP)
An overview of a CMS demonstration to develop and test new models of integrated, coordinated health care in the most sparsely-populated rural counties with the goal of improving health outcomes and reducing Medicare expenditures.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Community Hospital Demonstration
An overview of a CMS demonstration project which provides cost-based reimbursement for small rural hospitals too large to be Critical Access Hospitals. Examines the community benefits and financial impact for participating hospitals.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Data.CMS.gov
Interactive tool for identifying Centers for Medicare and Medicaid Services (CMS) data and information resources. Sources can be narrowed by the geographic level available, including state, county, rural and urban, and more. Sources can also be viewed by CMS program, topic, and setting of care.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Swing Bed Services
Provides information about the requirements Critical Access Hospitals must meet in order to enter into a swing bed agreement under which they can use beds, as needed, to provide either acute or Skilled Nursing Facility care.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Telehealth & Remote Patient Monitoring
Contains information on originating sites, distant site practitioners, telehealth services, billing and payment for professional services furnished via telehealth as well as for the originating site facility fee, telehealth home health, remote patient monitoring, and a list of helpful websites.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Oregon Office of Rural Health Maps
Offers a compilation of maps of Oregon on topics including urban and rural designations, healthcare providers and facilities, population demographics, and more. Several maps include county-level data.
Sponsoring organization: Oregon Office of Rural Health
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