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Rural Health
Resources by Topic: Reimbursement and payment models

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 initial demonstration ended in July 2019. However, the Consolidated Appropriations Act, 2021, authorized a five-year extension period for participating Critical Access Hospitals.
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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Medicare Learning Network: Home Health Prospective Payment System
Provides education on the Home Health Prospective Payment System (HH PPS) including background information and consolidated billing requirements, coverage of HH services, elements of the HH PPS, and additional requirements. Includes information on payment adjustments for rural areas.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS Ambulances Services Center
Resources and information for Medicare ambulance services. Provides access to policies and regulations, fees and billing, manuals, educational opportunities, and more.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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