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Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

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: Information for Critical Access Hospitals
Booklet providing information about Critical Access Hospital (CAH) designation and payments. Discusses the use of CAH beds for general inpatient hospice care and conversion to Rural Emergency Hospital (REH) status. 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 & Coverage
Provides information 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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Social Security Act, Section 1833 (f) and (h): Payment of Benefits
Payment limits for Rural Health Clinics and clinical laboratory services under the Social Security Act.
Type: Document
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