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CMS releases updated guidance for hospitals interested in Medicare, Medicaid as a rural emergency hospital

On September 11, the Centers for Medicare & Medicaid Services (CMS) issued updated guidance on the conditions of participation and the conversion process for hospitals seeking to become Rural Emergency Hospitals (REHs) under Medicare and Medicaid. Established by the Consolidated Appropriations Act of 2021, REHs are designed to address the issue of rural hospital closures by providing emergency and outpatient services to patients who typically stay less than 24 hours.

Since January 1, 2023, Medicare has provided REHs with an additional 5% payment above the hospital outpatient prospective payment system (OPPS) rate for delivering emergency, observation, and other outpatient services to Medicare patients. Covered services at REHs include radiology, laboratory tests, outpatient rehabilitation, surgical procedures, maternal health, and behavioral health. However, copayments for REH services follow the standard OPPS rate, excluding the additional 5% payment increase. For further details, CMS has released a fact sheet on REHs.

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