Rural Health

Information Resource

Highlights

Stay Informed - Go to CMS Mailing Lists to join a provider specific listserv (or electronic mailing list service) to receive news from CMS.

Billing/Payment

HIPAA Information for Medicare Providers

HIPAA Information for Medicare and Non-Medicare Providers

Medicare Information for Health Professional Shortage Areas (HPSAs) and Physician Scarcity Areas (PSAs)

CMS Manuals and Transmittals

• CMS Manual System (Internet-Only Manuals) -- Effective October 1, 2003, CMS transitioned from a paper-based to a web-based manual system.
• Rural Health Clinics and Federal Qualified Health Centers, Chapter 9 (pdf 267Kb)
• Medicare Benefit Policy Internet Only Manual (pdf format 317Kb)
• State Medicaid Manual
• Payment for Services: State Plan Amendments (pdf format 517Kb, page 6-51)
• Rural Health Clinic Paper-Based Manual
• Medicare Rural Health Clinic and Federally Qualified Health Center Manual (Pub 27) -- Crosswalks from Paper-Based Manuals to Internet-Only Manuals
• Reimbursement Manual (Zip format 56Kb)
• Rural Health Program Transmittals
• MSP Manual - Provider Billing Requirements

Medicare National Coverage Determinations Manual

Enrollment/Participation/Certification

Enrollment

• Federal Health Care Provider/Supplier Enrollment Form
  • CMS 855 Form User Guide
• Form CMS-1561A (pdf format 27Kb)
• Form CMS-29 (pdf format 31 Kb)

Rural Health Clinic Enrollment

General Information, Eligibility and Entitlement

Conditions of Participation

Survey and Certification

Coding

Healthcare Common Procedure Coding System (HCPCS)

Alpha-Numeric HCPCS File

ICD9-CM Coordination and Maintenance Committee
This site includes links to the ICD-9 codes.

ICD-9-CM Diagnosis and Surgical Codes

• ICD-9 Conversion Table: A conversion table for diagnostic and procedural code changes between 1986-2004 is provided to assist users in data retrival. The table shows the date the new code became effective and its previously assigned code equivalent.

ICD-9 Coding Resources on Medlearn Effective October 1, 2003

Policies/Regulations

Medicare Modernization Act

Medicare Modernization Updates

Quarterly Provider Update -- Regulations Published This Quarter

Quarterly Provider Update -- Rural Health Centers

• CMS-1727-P, (adobe pdf 319Kb) Published at the Office of the Federal Register June 25, 2004
• CMS-1727-P (Microsoft Word zipped 114Kb) On Display June 24, 2004

Health Insurance Portability and Accountability Act (HIPAA)

• CMS-0045-F - HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers

Coverage

Medicare Coverage Homepage

Medicare Coverage Database contains National Coverage Determination(NCDs), National Coverage Analyses(NCAs), and Local Medical Review Policy (LMRPs)

Medicare National Coverage Determinations Manual

Medicare Secondary Payer

Medicare Secondary Payer Manual

Medicare Coordination of Benefits

Program Integrity/Medical Review

Fighting Fraud and Abuse

Medicare Medical Review Program

Medicare Integrity Program

Education

Medicare Learning Network (Medlearn)

"Medlearn Matters...Information for Medicare Providers"articles are designed to help providers understand new or changed Medicare policy Subscribe to the Medlearn Matters electronic mailing list

• Order Education and training Products -- including: Web Based Training (WBT) modules, Satellite Broadcasts, Publications, CD ROMs, and VHS Videos

Medlearn Matters Frequently Asked Questions

Research and Statistics

Exclusions from SNF PPS - Issue Paper (pdf format 23Kb)

Vulnerability of Rural Hospitals to Medicare Outpatient Payment Reform (pdf format 186Kb

How to Stay Informed

The CMS Quarterly Provider Update

CMS Quarterly Provider Update - Rural Health Centers

Open Door Forum: Rural Health and Federally Qualified Health Centers (FQHC)

Contacts

Contact Your Carrier/FI via Toll-Free Numbers and Websites -- A listing of the new toll free numbers that CMS has installed at Medicare contractor sites

• Regional Home Health Intermediary (RHHI)

CMS Regional Office Contacts

CMS Resources

Critical Access Hospitals (CAH)

Medicare Drugs

Therapy Resources

Medicaid Services

Federally Qualified Health Centers Home Page

Partnerships

Telehealth

Tribal Governments

Publications

Privacy of Medical Record Information in Rural Health Clinics

Medicaid: Perspectives on the Past, Present, and Future (pdf format 1.1Mb)

Rural Health Center Fact Sheet (pdf format 47Kb)

Sole Community Hospital - (pdf format 40Kb) Fact Sheet

Federally Qualified Health Center Fact Sheet (pdf format 55Kb)

Critical Access Hospital Program - (pdf format 112Kb) Fact Sheet

Helpful Links

• National Rural Health Association
• Health Resources and Services Administration (HHS)
• National Association of Rural Health Clinics
• Rural Assistance Center
• The Frontier Education Center
• Technical Assistance and Services Center (TASC) - for the Rural Hospital Flexibility Program
• The National Rural Recruitment and Retention Network (3R Net)
• National Association for Rural Mental Health (NARMH)
• Project HOPE Walsh Center for Rural Health Analysis
• The Kaiser Commission: Health Insurance Coverage in Rural America
• The Kaiser Commission: The Uninsured in Rural America