Rural Health
Resources by Topic: Medicare

Medicare Payment Basics: Inpatient Psychiatric Facilities Services Payment System
Overview of Medicare's payment system for inpatient psychiatric services provided in freestanding hospitals or specialized hospital-based units. Demonstrates how payments for these services are adjusted to reflect geographic differences in labor costs, and cost of care by facility and patient characteristics.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
view details

Medicare Payment Basics: Inpatient Rehabilitation Facilities Payment System
Overview of Medicare's payment system for inpatient rehabilitation services in freestanding facilities or within acute care hospitals. Demonstrates how payment rates are adjusted to account for certain facility characteristics, including facilities in rural areas.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
view details

Medicare Payment Basics: Outpatient Hospital Services Payment System
Outlines Medicare's payments for outpatient hospital services, including considerations for rural sole community hospitals.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
view details

Medicare Payment Basics: Part D Payment System
Overview of the Medicare Part D prescription drug benefit, including subsidy amounts, payments to plans, how enrollee premiums are calculated, and benefit and payment updates.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
view details

Medicare Payment Basics: Physician and Other Health Professional Payment System
Overview of Medicare payments for physician services conducted in a variety of settings including physicians' offices, hospitals, ambulatory surgical centers, skilled nursing facilities and other post-acute care settings, hospices, outpatient dialysis facilities, clinical laboratories, and beneficiaries' homes.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
view details

Medicare Payment Basics: Skilled Nursing Facility Services Payment System
Overview of Medicare payments for skilled nursing and rehabilitation services. Describes what constitutes a skilled nursing facility and how small, rural hospitals and Critical Access Hospitals (CAHs) may be used to provide these services with CMS approval. Compares Medicare daily base rates for urban and rural skilled nursing facilities.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
view details

Medicare Payment Basics: Medicare Advantage Program Payment System
Overview of Medicare payments to Medicare Advantage (MA) local and regional plans discussing the methods for determining Medicare payments to both plans.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
view details

Report to the Secretary of Health and Human Services: Reducing Barriers to Participation in Population-Based Total Cost of Care (PB-TCOC) Models and Supporting Primary and Specialty Care Transformation
Summarizes findings from the Physician-Focused Payment Model Technical Advisory Committee's (PTAC) review of information on reducing barriers to participation in alternative payment models (APMs). Discusses key issues relating to reducing barriers to participation in APMs and value-based care transformation, areas where additional research is needed, and potential next steps.
Date: 10/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
view details

Medicare Advantage Enrollees Have Access to About Half of the Physicians Available to Traditional Medicare Beneficiaries
Explores how provider networks vary across Medicare Advantage plans and when compared to traditional Medicare. Examines the share of physicians available to Medicare Advantage enrollees as a share of physicians available to traditional Medicare beneficiaries by analyzing Medicare Advantage provider directories for 2022. Includes information on the availability of physicians to Medicare Advantage enrollees and traditional Medicare beneficiaries in rural counties.
Author(s): Matthew Rae, Jeannie Fuglesten Biniek, Tricia Neuman, Karen Pollitz
Date: 10/2025
Sponsoring organization: KFF
view details

Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2026. Summarizes provisions related to telehealth services; improving care for chronic illness and behavioral health needs; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, services requiring direct supervision, and telecommunication services; and more.
Date: 10/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
view details