Rural Graduate Medical Education Analyzer

This tool is designed to produce a report for rural hospitals interested in starting residency training programs to determine possible qualification for Medicare Graduate Medical Education payments. In order for rural hospitals to newly qualify for Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments, hospitals must:

• Be located in a rural area. For the purposes of this tool, ‘rural’ is defined as all counties that are not designated as parts of Metropolitan Areas (MA), as specified at 42 CFR 412.64(b)(1)(ii)(C).
• Have no prior evidence of resident training since 1996 and/ or thereafter as reported on Center for Medicare & Medicaid Services (CMS) Cost Reports (Hospital Form 2552-96 and Hospital Form 2552-10) (i.e. no DGME payments, no IME payments, no Training Costs)

Facilities included in this tool are those that have CMS Cost Reports (Hospital Form 2552-96 and Hospital Form 2552-10) (such as PPS hospitals, Sole Community Hospitals, etc.). Critical Access Hospitals (CAHs) are not included. CAHs and their hospital owned clinics receive only direct cost reimbursement for allowable teaching costs, not IME, and are not subject to a Medicare cap for resident training.

Please note that the determination provided by this tool is not a legal justification to qualify for Medicare Graduate Medical Education (GME) payments. Hospitals desiring to begin a residency training program are advised to speak with their Medicare Administrative Contractor (MAC) to confirm their Medicare resident cap status.