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Rural Health
Resources by Topic: Reimbursement and payment models

CMS Innovation Center
Supports the development, testing and sharing of innovative healthcare payment and service delivery models. Includes data, reports, webinars and forums for sharing knowledge among healthcare innovators, data researchers and policy analysts.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Acute Care Hospital Inpatient Prospective Payment System
Provides general information about the Acute Inpatient Prospective Payment System (IPPS), including IPPS payment rates and how IPPS payment rates are set. Includes sections on the Rural Referral Center (RRC) Program and the Sole Community Hospital (SCH) designation.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Billing Guide
Describes the information Federally Qualified Health Centers are required to submit for a Prospective Payment System, and explains how Rural Health Clinics should bill for certain preventive services under the Affordable Care Act.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Billing Information for Rural Providers and Suppliers
Provides Medicare billing information by provider type and type of service, including information on where to submit claims. Includes information for Critical Access Hospitals, Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), Skilled Nursing Facilities, Home Health Agencies, and Swing Bed services.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Rural Health Clinic
Provides an overview of the Rural Health Clinic (RHC) program and services. Includes information regarding Medicare certification.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Medicare Disproportionate Share Hospital
Provides an overview of the Medicare Disproportionate Share Hospital (DSH) adjustment provision and lists requirements that hospitals must meet in order to qualify for it.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Critical Access Hospital
Booklet providing information about Critical Access Hospital (CAH) designation and payments. Includes a list of CAH resources and helpful websites.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Federally Qualified Health Center
Provides a general overview of Federally Qualified Health Centers (FQHCs) and includes a list of helpful rural health resources and websites.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Frontier Community Health Integration Project (FCHIP) Demonstration
Describes the Frontier Community Health Integration Project (FCHIP) demonstration including the project purpose, legislation, eligible states, partners, and program contacts. The demonstration ended in July 2019.
Type: Website
Sponsoring organization: Rural Health Information Hub
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Health.mil Rates and Reimbursement: Hospital Classifications
Identifies TRICARE reimbursement methodologies for Sole Community Hospitals (SCH) and Critical Access Hospitals (CAHs). Also lists CAH inpatient and outpatient cost to charge ratios (CCRs).
Type: Website
Sponsoring organization: Military Health System
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