Rural Health
Resources by Topic: Reimbursement and payment models
Merit-Based Incentive Payment System (MIPS): 2026 Reporting MIPS Quality Measures through Medicare Part B Claims Quick Start Guide for Small Practices
Provides details on how small practices can report quality measures through Medicare Part B claims measures. Highlights changes to these measures in 2026, score redistribution policies for small practices, and information for clinicians at Critical Access Hospitals.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides details on how small practices can report quality measures through Medicare Part B claims measures. Highlights changes to these measures in 2026, score redistribution policies for small practices, and information for clinicians at Critical Access Hospitals.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Care Management Opportunities - What's New in 2026?
Recording of a December 17, 2025, webinar on care management practices in Rural Health Clinics, associated Medicare care management codes, and changes over time in billing requirements and implementation. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: 2026 Care Management Codes and Reimbursement, Presentation Slides
Date: 12/2025
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a December 17, 2025, webinar on care management practices in Rural Health Clinics, associated Medicare care management codes, and changes over time in billing requirements and implementation. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: 2026 Care Management Codes and Reimbursement, Presentation Slides
Date: 12/2025
Sponsoring organization: National Association of Rural Health Clinics
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Rural Health Transformation Program State Application Summary: State-level Initiatives & Proposed Activities
Summarizes focus areas for each state in the applications for the Rural Health Transformation Program and highlights common themes across all applications.
Date: 12/2025
Sponsoring organization: National Rural Health Association
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Summarizes focus areas for each state in the applications for the Rural Health Transformation Program and highlights common themes across all applications.
Date: 12/2025
Sponsoring organization: National Rural Health Association
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December 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2025 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, Rural Emergency Hospitals (REHs), post-acute care, skilled nursing facility services, inpatient rehabilitation facility services, home health services, hospice services, and outpatient dialysis services. Includes discussions on improving Medicare payment approaches and mandated reports on the impact of recent changes to the home health prospective payment system and an assessment of the Medicare ground ambulance data collection system.
Additional links: Assessing Payment Adequacy and Updating Payments: Hospital Inpatient and Outpatient Services; Mandated Report on Rural Emergency Hospitals; And Update on Site-neutral Payments - Presentation Slides, Mandated Report: Assessment of the Medicare Ground Ambulance Data Collection System - Presentation Slides
Date: 12/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2025 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, Rural Emergency Hospitals (REHs), post-acute care, skilled nursing facility services, inpatient rehabilitation facility services, home health services, hospice services, and outpatient dialysis services. Includes discussions on improving Medicare payment approaches and mandated reports on the impact of recent changes to the home health prospective payment system and an assessment of the Medicare ground ambulance data collection system.
Additional links: Assessing Payment Adequacy and Updating Payments: Hospital Inpatient and Outpatient Services; Mandated Report on Rural Emergency Hospitals; And Update on Site-neutral Payments - Presentation Slides, Mandated Report: Assessment of the Medicare Ground Ambulance Data Collection System - Presentation Slides
Date: 12/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Merit-Based Incentive Payment System (MIPS): Traditional MIPS Scoring Guide for the 2025 Performance Year
Provides details on how scores are calculated for the Merit-Based Incentive Payment System (MIPS), one of two tracks under the Medicare Quality Payment Program. Explains the four performance categories that affect Medicare Physician Fee Schedule payments: quality, cost, improvement activities, and promoting interoperability. Includes information for small practices.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides details on how scores are calculated for the Merit-Based Incentive Payment System (MIPS), one of two tracks under the Medicare Quality Payment Program. Explains the four performance categories that affect Medicare Physician Fee Schedule payments: quality, cost, improvement activities, and promoting interoperability. Includes information for small practices.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Merit-Based Incentive Payment System (MIPS): 2025 Merit-Based Incentive Payment (MIPS) Value Pathways (MVPs) Implementation Guide
Provides an overview of the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs), a voluntary reporting option that can be used to meet MIPS reporting requirements for the 2025 performance year. Describes subgroup reporting, reporting requirements, scoring, performance feedback and public reporting, and how to register to report an MVP. Includes information on considerations and exceptions for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs), a voluntary reporting option that can be used to meet MIPS reporting requirements for the 2025 performance year. Describes subgroup reporting, reporting requirements, scoring, performance feedback and public reporting, and how to register to report an MVP. Includes information on considerations and exceptions for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Telehealth FAQ Calendar Year 2026
Provides information on Medicare telehealth regulations and payment policy for calendar year 2026. Includes information on audio-only services, behavioral health services, direct supervision, and more. Highlights changes that take effect on January 31, 2026 under current law.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on Medicare telehealth regulations and payment policy for calendar year 2026. Includes information on audio-only services, behavioral health services, direct supervision, and more. Highlights changes that take effect on January 31, 2026 under current law.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Calendar Year 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Final Rule (CMS-1834-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2026. Summarizes provisions regarding changes to hospital price transparency; Intensive Outpatient Program (IOP) and partial hospital program rate setting; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; hospital quality start ratings; and more.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2026. Summarizes provisions regarding changes to hospital price transparency; Intensive Outpatient Program (IOP) and partial hospital program rate setting; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; hospital quality start ratings; and more.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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RHCs and CAHs Participating in the Medicare Shared Savings Program (MSSP): Characteristics of the Providers and Communities
Describes the characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) currently participating in the Medicare Shared Savings Program (MSSP) in 2023. Compares CAH and RHC characteristics by MSSP participation, ownership status, and free-standing versus provider-based RHC status.
Author(s): Edmer Lazaro, Dan Shane, Fred Ullrich, Keith Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Describes the characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) currently participating in the Medicare Shared Savings Program (MSSP) in 2023. Compares CAH and RHC characteristics by MSSP participation, ownership status, and free-standing versus provider-based RHC status.
Author(s): Edmer Lazaro, Dan Shane, Fred Ullrich, Keith Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Third Party Negotiated Hospital Pricing in Rural and Urban Hospitals within 12 U.S. States
Examines the gross and negotiated pricing for common services in rural and urban hospitals. Bases findings on samples from 12 states and focuses on costs of routine care, imaging, and childbirth.
Author(s): Lindsey R. Hammerslag, Aaron P. Smith, Jeffrey C. Talbert
Date: 11/2025
Sponsoring organization: Rural and Underserved Health Research Center
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Examines the gross and negotiated pricing for common services in rural and urban hospitals. Bases findings on samples from 12 states and focuses on costs of routine care, imaging, and childbirth.
Author(s): Lindsey R. Hammerslag, Aaron P. Smith, Jeffrey C. Talbert
Date: 11/2025
Sponsoring organization: Rural and Underserved Health Research Center
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