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

The Centers for Medicare & Medicaid Services Sept. 11 released revised guidance regarding conditions of participation and the conversion process for eligible hospitals interested in participating in Medicare and Medicaid as a rural emergency hospital. REHs are a new provider type established by the Consolidated Appropriations Act of 2021 to address concerns about rural hospital closures. They provide emergency and outpatient medical and health services to patients that typically stay less than 24 hours.

As of Jan. 1, 2023, Medicare pays REHs an additional 5% over the hospital outpatient prospective payment system rate to deliver emergency, observation and other outpatient services to Medicare patients. Medicare-covered REH services include all covered outpatient services, including radiology, laboratory, outpatient rehabilitation, surgical, maternal health and behavioral health. Copayments for REH services are based on the standard OPPS rate, which excludes the 5% increase. CMS has also released a fact sheet explaining more about REHs.