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Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

Home Health Prospective Payment System Regulations and Notices
Lists federal regulations and notices related to the Home Health Prospective Payment System, including information on annual payment rate updates. Contains copies of proposed and final rules, along with any relevant corrections, as published in the Federal Register.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Ambulatory Surgical Center (ASC) Regulations and Notices
Lists federal regulations and notices related to the Ambulatory Surgical Center (ASC) Payment System, including information on annual payment rate updates. Contains copies of proposed and final rules, along with any relevant corrections, as published in the Federal Register.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Acute Inpatient Prospective Payment System (IPPS) Regulations and Notices
Lists federal regulations and notices related to the Acute Inpatient Prospective Payment System (IPPS), including information on annual payment rate updates. Contains copies of proposed and final rules, along with any relevant corrections, as published in the Federal Register.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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ValView 2022 MIPS Estimator
Web-based tool allows providers to calculate a composite Merit-Based Incentive Payment System (MIPS) score. Presents data submission methods to produce the highest base-line score and enables workflow adjustments to improve patient outcomes.
Type: Tool
Sponsoring organization: Valview by Marsden Advisors
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Care Management Medicare Reimbursement Strategies for Rural Providers
Information for rural healthcare providers on Medicare billing codes for services to keep beneficiaries healthy and better coordinate services to support beneficiaries at home. Addresses Annual Wellness Visits, Chronic Care Management, Transitional Care Management, and Principal Care Management.
Type: Website
Sponsoring organizations: NORC Walsh Center for Rural Health Analysis, Rural Health Information Hub
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Quality Payment Program (QPP) Small Practices
Section of the Quality Payment Program (QPP) website offering free resources and updates for practices with 15 or fewer clinicians participating in QPP. Includes resources on Merit-based Incentive Payment System (MIPS) eligibility, how to choose and report on quality measures, and flexibilities and reporting options to help clinicians in small practices meaningfully participate and succeed in MIPS.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Health Professional Shortage Area Physician Bonus Program
Provides an overview of the Health Professional Shortage Area (HPSA) Physician Bonus Program and explains how bonus payments are calculated and paid. Includes information related to Critical Access Hospitals (CAHs) as well as primary care and mental health HPSAs.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Advantage Rates & Statistics
Provides links to information for Medicare Advantage (MA) organizations regarding MA payment policies, including announcements on payment methodology and advance notices of changes, rate books and supporting data, fee-for-service expenditure data by county, and more.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Community Hospital Demonstration
An overview of a CMS demonstration project which provides cost-based reimbursement for small rural hospitals too large to be Critical Access Hospitals. Examines the community benefits and financial impact for participating hospitals.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Telehealth Services
Contains information on originating sites, distant site practitioners, telehealth services, billing and payment for professional services furnished via telehealth as well as for the originating site facility fee, and a list of helpful websites.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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