Rural Health
Resources by Topic: Reimbursement and payment models

Medicare Payment Basics: Long-term Care Hospitals Payment System
Overview of Medicare payments for long-term care hospitals (LTCH) and services. Discusses the LTCH prospective payment system (PPS) and payment rate settings for LTCH and site-neutral cases.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Home Health Care Services Payment System
Overview of Medicare payments for home health care services. Includes information on rate-setting and payments for quality reporting and performance. Describes the Patient-Driven Groupings Model (PDGM) and the home health resource groups (HHRGs) based on clinical and functional status.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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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
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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
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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
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Medicare Payment Basics: Durable Medical Equipment Payment System
Overview of Medicare payments for medical equipment used to treat beneficiaries at home. Defines durable medical equipment (DME), details the DME fee schedule, and discusses the competitive bidding program (CBP) for DME. Includes information on adjustments to fee schedule payment rates outside of competitive bidding areas (CBAs).
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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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
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Medicare Payment Basics: Ambulance Services Payment System
Provides an overview of Medicare payments for ambulance services. Discusses rural add-on payment policies, geographic categories determining payment rates, super-rural ZIP codes, and ambulance fee schedules.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Accountable Care Organizations Payment Systems
Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Critical Access Hospitals Payment System
Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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