How Rural Practices Are Using Rural Health Transformation (RHT) Funds to Launch Remote Care Programs
The Rural Health Transformation (RHT) Program represents the largest concentrated investment in rural healthcare infrastructure in United States history: $50 billion over five fiscal years, distributed to states through cooperative agreements. Across the state plans submitted to CMS, remote care (Remote Patient Monitoring, Chronic Care Management, Principal Care Management, and Advanced Primary Care Management) appears in nearly every funded strategy. This guide explains how rural practices, Federally Qualified Health Centers (FQHCs), and Rural Health Clinics (RHCs) can position remote care within RHT-funded programs, what the program supports, and what to consider operationally when building or expanding remote care against RHT timelines.
Quick reference.
$50 billion over FY 2026 to FY 2030. $10 billion annually. 50% distributed equally to approved states, 50% by metrics. First-year awards average approximately $200 million per state, with significant variation. Sub-awards flow from states to providers based on each state’s approved plan and procurement framework.
What the RHT Program funds, in brief
The RHT Program was authorized under Public Law 119-21, the Working Families Tax Cuts Act, signed July 4, 2025. Administration sits with the Office of Rural Health Transformation (ORHT) within the Center for Medicaid and CHIP Services. The program distributes funds through cooperative agreements with approved states, and states then sub-award to providers, networks, and consortiums based on each state’s plan.
CMS organized the program around five strategic goals: Making Rural America Healthy Again, Sustainable Access, Workforce Development, Innovative Care Models, and Tech Innovation. State plans must demonstrate alignment with these goals, and sub-awards are evaluated on the same framework.
Funding is not a grant in the traditional sense. It is structured as multi-year transformation capital, with state-level project abstracts naming specific investment categories. For rural practices and safety-net providers, the operational question is which categories in your state’s plan most closely match what your organization is positioned to build.
Why remote care appears in nearly every state RHT plan
Remote care does the work that the RHT strategic goals require. Remote Patient Monitoring extends the clinical reach of staff in geographies where recruitment is the binding constraint. Chronic Care Management and Advanced Primary Care Management provide structured non-face-to-face care coordination that the program’s value-based care priority is built around. Continuous physiologic monitoring reduces the high-cost emergency department utilization that defines rural healthcare cost pressure.
This is reflected in the state plans:
- Texas directed a significant portion of its allocation to its “Rural Texas Strong” initiative, with explicit focus on Remote Patient Monitoring for chronic disease management.
- New Jersey designated a $9 million Tech Solutions RFP that includes remote monitoring as a named investment area, alongside a $10 million Rural Health Clinical Workforce retention program.
- South Carolina structured its plan around “Connections to Care” and “Wellness Within Reach” programs, with mobile health, chronic disease management, and digital health literacy as central pillars.
- Georgia committed to robust telemedicine infrastructure expansion alongside obstetric and emergency care investments.
- Tennessee, Kentucky, Alabama, Massachusetts, Iowa, and others list remote care, chronic disease management, telehealth hubs, or technology deployment as primary investment areas.
The pattern across the state plans is consistent: technology that extends clinical reach is treated as core infrastructure, not optional add-on.
How rural practices and FQHCs can position remote care in RHT-funded programs
1. Align with state strategic priorities
Each state’s RHT plan and project abstract names specific investment areas. Funding requests that map to the language CMS reviewers will recognize have a structural advantage. Read your state’s project abstract before drafting any sub-award proposal.
2. Build collaborative, network-based proposals
CMS scoring explicitly rewards Clinically Integrated Networks and hub-and-spoke models. Single-entity applications are at a structural disadvantage. Practices that pair with neighboring critical access hospitals, FQHCs, RHCs, or specialty groups present a stronger case for sustainable shared infrastructure.
3. Quantify the workforce extension argument
Remote care platforms with care navigators reduce the per-patient time required of in-house clinical staff. For rural geographies where recruitment is the binding constraint, this is the clinical labor argument that resonates with state reviewers. Frame the technology purchase as a workforce extension strategy, not a standalone tool.
4. Plan for value-based care reporting from day one
RHT funds are heavily oriented toward value-based care transition. Remote care programs that document clinical outcomes (blood pressure control rates, A1c reduction, emergency department utilization, 30-day readmission rates) from launch are positioned for sub-award renewal in years two and three of the cooperative agreement.
Talk through your state’s RHT plan with our team
In one working session we map which of RPM, CCM, PCM, and APCM fit your panel, how they line up with your state’s named investment priorities, and how to position them in a sub-award. You leave with a concrete plan, not a sales pitch.
Operational building blocks of an RHT-ready remote care program
State reviewers and sub-award committees evaluate proposed remote care programs against operational specifics, not against the general concept of remote monitoring. The building blocks that hold up to scrutiny include:
Cellular-enabled connected medical devices
Rural geographies often lack reliable Wi-Fi. Devices that transmit physiologic data over cellular networks (blood pressure, blood glucose, pulse oximetry, weight) work without requiring patient internet access. This is foundational for any rural remote care program.
Care navigators, not call center staff
Licensed clinical staff (LPN, RN) operate as an extension of the practice’s care team, reviewing readings, conducting monthly check-ins for CCM and APCM, and escalating critical findings to the treating provider per documented protocol. This staffing model is what RHT-scoring values, not contact-center coverage.
Documentation and billing aligned to 2026 CMS standards
RPM device supply codes 99454 and 99445 reflect the 2026 two-day adherence floor. CCM billing under CPT 99490 requires documented 20-minute monthly coordination. APCM operates on monthly bundled per-beneficiary payments under HCPCS G0556 through G0558. Programs built to current standards from day one avoid expensive retrofits later.
EMR integration that supports actual clinical workflow
Bidirectional integration with the practice’s EMR is the operational test of whether the remote care program adds clinical value or administrative burden. For RHT-funded programs that will be evaluated on outcomes, EMR integration is required, not optional.
Reporting infrastructure for value-based care metrics
Clinical outcomes, patient adherence, and population-level metrics need to be reportable from the platform without manual aggregation. RHT-funded programs are accountable to their state’s reporting framework, and sub-award renewals depend on documented results.
The fit between RHT priorities and remote care programs
The four CMS-recognized remote care programs map differently to the five RHT strategic goals:
| Program | Primary RHT goal alignment | Rural practice fit |
|---|---|---|
| Remote Patient Monitoring (RPM) | Healthy Again; Innovative Care Models; Tech Innovation | Chronic disease management. Reduces ED utilization. Workforce extension. |
| Chronic Care Management (CCM) | Healthy Again; Innovative Care Models | Structured non-face-to-face coordination. Predictable monthly revenue. Multi-condition patients. |
| Principal Care Management (PCM) | Innovative Care Models | Single high-acuity chronic condition. Specialty-adjacent. |
| Advanced Primary Care Management (APCM) | Sustainable Access; Innovative Care Models | Bundled monthly payment stabilizes primary care revenue. Eliminates minute-tracking burden. |
Many rural practices benefit from stacking programs. RPM and CCM are commonly run concurrently for patients with chronic conditions plus active physiologic monitoring needs. APCM and RPM stacking is encouraged under CMS guidance for primary care panels. Not sure which mix fits your panel? Talk it through with our team.
Practical steps for practices preparing to apply or receive sub-awards
- Identify your state’s RHT distributional authority and procurement timeline. Some states (Texas, Tennessee, South Carolina) have already established dedicated portals. Others are distributing through governors’ offices or third-party advisory committees.
- Review your state’s project abstract for named remote care investments. The CMS-published state abstracts list specific investment categories. Map your proposed program to the language used.
- Audit your current remote care capabilities. If you do not already operate RPM, CCM, or APCM, identify the partner infrastructure that will let you launch within an RHT-friendly timeline.
- Build coalition. Reach out to neighboring providers, FQHCs, RHCs, or critical access hospitals. Joint proposals score better than single-entity submissions.
- Identify a remote care infrastructure partner. The partner needs to support FQHC and RHC billing requirements (individual care coordination codes under Revenue Code 052X, per the October 2025 transition) and produce reporting that maps to your state’s value-based care metrics.
- Document outcomes from day one. Clinical results documented from program launch position your organization for sub-award renewal and expansion.
Frequently asked questions
Are RPM and CCM eligible for RHT funding?
Yes. Multiple state RHT plans list remote monitoring, chronic care management, and telehealth infrastructure as primary investment areas. Specific eligibility depends on your state’s plan and the sub-award terms.
Can a single rural practice apply directly to CMS for RHT funds?
No. RHT funds flow through state cooperative agreements. Practices receive sub-awards from their state’s distributional authority. Identifying that authority is the first step.
Does the RHT Program cover device costs, software, and clinical staffing?
Yes, where aligned with state plan priorities. Most state plans include hardware, software, telehealth infrastructure, and workforce expansion as eligible categories. Confirm specific eligibility against your state’s published abstract.
How does RHT funding interact with existing FQHC and RHC billing for CCM and APCM?
They are separate mechanisms. RHT funds support infrastructure, technology, and workforce development. FQHCs and RHCs continue to bill individual care coordination codes (G0556, G0557, G0558) under Revenue Code 052X, per the October 2025 transition from the legacy G0511 bundle.
When do funds become available?
First-year awards began in FY 2026. State procurement and sub-award timelines vary. Some states have already issued RFPs; others are in development. Monitor your state health department portal for the current procurement window.
What clinical outcomes should rural remote care programs document?
Blood pressure control, A1c reduction, emergency department utilization reduction, 30-day readmission rates, and program adherence. These align with both CMS RPM/CCM billing requirements and value-based care reporting under RHT scoring.
Does APCM apply to rural practices?
APCM is restricted to primary care specialties (Family Medicine, Internal Medicine, Geriatrics, Pediatrics). Rural primary care practices and FQHCs operating primary care services are eligible. Specialty rural practices are not eligible for APCM but can still bill RPM and CCM.
Build remote care that fits your state’s RHT plan
For rural practices, FQHCs, and RHCs evaluating remote care as part of RHT-funded program design, a consultation is the most direct path to understanding which combination of RPM, CCM, PCM, and APCM fits your patient panel and your state’s funding priorities.
For practices ready to evaluate APCM as part of an RHT-aligned primary care strategy, the 2026 APCM Vendor Evaluation Guide walks through the seven criteria practices should use to evaluate vendors before committing.