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Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under the AIR
Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on the Payment System for Inpatient Psychiatric Facilities for FY 2025
Comment on an April 3, 2024, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2025. Includes a discussion of rural IPF PPS payment adjustments.
Date: 05/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Converting to Rural Emergency Hospitals
Podcast episode featuring a discussion with Rural Emergency Hospital (REH) Chief Executive Officers in New Mexico and Oklahoma regarding the conversion to REH status. Discusses the conversion process of each REH; how they built trust and buy-in from patients and communities, including state and federal policymakers; and financial considerations of conversion.
Date: 05/2024
Type: Audio
Sponsoring organization: American Hospital Association
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Time for Action: Securing A Strong Nursing Workforce for North Carolina
Offers 8 recommendations for developing the nursing workforce in North Carolina. Discusses the workforce pipeline, professional education, well-being and safety in the workplace, leadership, retention, advocacy, staffing standards, billing, and more. Discusses rural throughout.
Date: 05/2024
Type: Document
Sponsoring organization: North Carolina Institute of Medicine
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Telehealth Policies and Federally Qualified Health Centers, Spring 2024
Provides an overview of telehealth policies for Federally Qualified Health Centers (FQHCs). Covers originating and distance sites, reimbursement, services outside the four walls of the FQHC, and more. Includes a chart of FQHC Medicaid telehealth reimbursement eligibility policies by state.
Date: 05/2024
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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New Medicare Behavioral Health Providers: Incorporating MHCs and MFTs Into Your RHC
Recording of a May 9, 2024, webinar discussing Medicare coverage of marriage and family therapists (MFTs) and mental health counselors (MHCs) effective January 1, 2024, and the implications for Rural Health Clinics. Describes skills and attributes of MFTs and MHCs and provides an overview of common mental health concerns for older adults. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 05/2024
Type: Document
Sponsoring organization: National Association of Rural Health Clinics
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Markup of H.R. 8261, H.R. 7931, H.R. 8245, H.R. 8244, H.R. 8235, and H.R. 8246
Recording of a May 8, 2024, House Ways and Means Committee markup of six bills regarding rural health. Legislation covers the extension of telehealth flexibilities, location requirements for Critical Access Hospitals in mountainous areas, the rural nursing home and physician workforce, and Rural Emergency Hospital eligibility.
Date: 05/2024
Type: Video/Multimedia
Sponsoring organization: House Ways and Means Committee
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Quality Payment Program (QPP) 2022: Participation and Payment Results At-a-Glance
Provides an overview of the results of the Quality Payment Program (QPP) for the 2022 performance year. Highlights the percentage of small and rural providers receiving negative, neutral, and positive payment adjustments for 2024.
Date: 05/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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2022 Quality Payment Program Experience Report
Reports on the clinician experience for those participating in the Quality Payment Program in 2022. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, mean and median final scores for 2022 and 2024 payment adjustments, and payment adjustment trends from 2019 through 2022.
Date: 05/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Merit-Based Incentive Payment System (MIPS): 2024 Merit-Based Incentive Payment (MIPS) Value Pathways (MVPs) Implementation Guide
Provides an overview of the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs), a voluntary reporting option that can be used to meet MIPS reporting requirements beginning with the 2024 performance year. Describes subgroup reporting, reporting requirements, scoring, performance feedback and public reporting, and how to register to report an MVP. Includes information on considerations and exceptions for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 05/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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