§ 419.92 Payment to rural emergency hospitals.

(a) Payment for REH services—(1) Medicare payment. A rural emergency hospital that furnishes a REH service on or after January 1, 2023, is paid an amount equal to the amount of payment that would otherwise apply under section 1833(t) of the Act for the equivalent covered OPD service, increased by 5 percent.

(2) Beneficiary copayment. The beneficiary copayment for a REH service is the amount determined under section 1833(t)(8) of the Act for the equivalent covered OPD service, excluding the 5 percent payment increase described in paragraph (a)(1) of this section.

(b) Monthly facility payment. Effective January 1, 2023, REHs are paid a monthly facility payment equal to 1⁄12 of the annual additional facility payment amount described in paragraphs (b)(1) and (2) of this section.

(1) Calculation of monthly facility payment for 2023. For calendar year 2023, the annual additional facility payment amount is:

(i) The total amount that the Secretary determines was paid by the Medicare program and from beneficiary copayments to all critical access hospitals in calendar year 2019; minus