The Rural Health Transformation (RHT) Program is one of the most significant federal healthcare investments in years, and rural providers should be paying close attention. Authorized by Congress and signed into law in July 2025, the program distributes $50 billion over five fiscal years to all 50 states to strengthen rural healthcare delivery.
Devised as a compromise for passage of the Medicaid cuts in the “One, Big, Beautiful Bill,” the RHT Program is not simply a financial lifeline for struggling hospitals. At its core, the program is a deliberate federal push to transform how chronic disease is prevented and managed in rural communities, and remote care management technology is increasingly central to how states are acting on that goal.
What the RHT Program Is Designed to Do
The RHT Program operates through state-level implementation. Each state submitted a comprehensive transformation plan to the Centers for Medicare & Medicaid Services (CMS) in 2025, detailing how it would invest funding to improve rural health outcomes. States were awarded total funds ranging from approximately $140 million to $280 million, with half of the overall pool distributed equally among states and the remainder allocated based on rural population and need.
All state plans were required to align with five core strategic goals established at the federal level: improving disease prevention and chronic disease management; strengthening provider sustainability; developing the rural healthcare workforce; growing innovative care models; and fostering technology adoption. The first goal — chronic disease prevention and management — is where remote care programs fit most naturally, and where many states are directing meaningful investment.
How States Are Directing Funds Toward Remote Care
Across the country, states have identified remote patient monitoring (RPM), telehealth, and electronic health record (EHR) modernization as priority investment areas. Several states — including Arkansas, Nebraska, Nevada, South Carolina, Vermont, and Washington — have directly allocated RHT funds for the purchase of RPM technology, including management software and patient devices. Eligible organizations, primarily critical access hospitals (CAHs), rural health clinics (RHCs), and federally qualified health centers (FQHCs), can apply through their state’s grant portal.
A separate group of states, including Arizona, California, Colorado, Louisiana, Minnesota, and New Mexico, has structured competitive grant opportunities tied specifically to implementing chronic care programs and equipping those programs with the necessary management and technology resources.
How states are distributing these funds also varies. Some are running statewide competitive procurements where rural hospitals and clinics apply directly for grants. Others are channeling funds through regional coalitions that sub-grant to local partners. Some have opted for direct, non-competitive allocations to existing providers, while several states are using hybrid approaches. Most states now maintain a dedicated RHT web page with program goals, funded priorities, and available grant opportunities — the right starting point for any provider exploring participation.
Why RPM and CCM Are a Strong Fit for This Moment
RPM and chronic care management (CCM) address the specific challenges the RHT Program is designed to solve. For a patient with hypertension or heart failure who lives an hour from the nearest clinic, a connected monitoring device and regular care management touchpoints can mean the difference between a controlled condition and a preventable hospitalization — without requiring that patient to be in a car every week.
The clinical evidence is compelling. Studies have documented RPM programs producing a 65% decline in hospital admissions for cardiovascular disease patients and mean HbA1c falling from 10.4% to 7.0% for diabetic patients. A recent Prevounce real-world retrospective analysis found similarly compelling blood pressure improvements when patients were stratified by hypertension stage, age, and program adherence. These outcomes map directly to the chronic disease management goals embedded in most state RHT plans — and the kind of data that makes for a strong grant application.
The operational value of RPM and CCM together is equally significant. They reduce the travel requirements on rural patients who can face significant barriers to frequent in-person care, expand care team capacity in markets where staffing shortages are persistent, and strengthen the patient-provider relationship through ongoing engagement rather than occasional visits. And because these services are reimbursed by Medicare on a recurring monthly basis, they generate a reliable, scalable revenue stream for clinics operating on tight margins — one that compounds as program enrollment grows.
Layered on top of RPM, CCM and advanced primary care management (APCM) complete the care infrastructure. CCM provides structured reimbursement for monthly care coordination for patients with two or more chronic conditions. APCM, introduced in 2025, offers a population-based alternative that does not require time tracking and can be layered with RPM for eligible patients. Together, they create a continuous care model built for the realities of rural practice — where geography limits visits but clinical need does not.
The 2026 Physician Fee Schedule also made RPM more accessible in ways that matter particularly for rural populations. Two new codes — CPT 99445, covering device supply for 2–15 monitoring days per month, and CPT 99470, covering care management time of 10–20 minutes — mean that patients who previously fell short of billing thresholds due to adherence challenges or lower-intensity monitoring needs can now be enrolled in a clinically appropriate, reimbursable program. For rural providers managing patients with real barriers to consistent device use, that flexibility is significant — and so is the financial impact. A practice with a typical RPM panel could see monthly reimbursement climb from roughly $42,000 to nearly $51,000 under the 2026 fee schedule, largely driven by the newly billable patient segments the prior codes excluded [See Figure 1].
Fig. 1: 2025 vs. 2026 RPM reimbursement comparison; rates reflect national average; actual reimbursement varies by locality.
Navigating RHT Funding Alongside Medicare Billing
Providers exploring RHT funding will need to understand one important constraint outlined in the federal policy: grant funds cannot replace payment for clinical services that could be reimbursed by insurance. States themselves are interpreting and enforcing this guideline differently. Given that RPM and CCM are Medicare-reimbursable services, providers should understand their state-specific rules before submitting a grant proposal and explain their planned use of funds clearly.
That said, there are two practical approaches that may work depending on the state. For organizations without an existing remote care program, RHT funds could cover the up-front technology investment in areas such as software, RPM devices, and electronic health record integration. The clinic could then proceed to bill for care management time under RPM or CCM, but not RPM device supply codes if grant funds were used to purchase devices. For organizations with an active program, RHT funds could support a separate patient population — such as patients whose insurance does not cover RPM — with devices redeployed into the Medicare-billable program when the grant period ends. Either way, the grant serves as a runway to a self-sustaining program.
The Broader Policy Signal
The RHT Program reflects a consistent and bipartisan federal direction toward longitudinal, technology-enabled care for patients with chronic conditions. The 2025 PFS introduced APCM. The 2026 PFS expanded RPM coding flexibility. CMS’s new Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) model offers outcome-aligned payments for technology-supported chronic disease management beginning in July 2026. And bipartisan legislation under consideration in Congress would waive RPM cost-sharing for beneficiaries and expand reimbursement equity for RPM in rural communities specifically.
Taken together, these developments make one thing clear: remote care management is not a program rural providers should continue deferring. The federal investment, policy alignment, and clinical evidence are all pointing in the same direction, and that window won’t stay open forever. Providers who understand how their state is deploying RHT funds, and who build or expand remote care programs with that context in mind, are well-positioned to improve patient outcomes and put their organizations on stronger financial footing for the years ahead.
Daniel Tashnek, JD, is the co-founder and CEO of Prevounce Health, a healthcare software and services company that simplifies the provision of remote patient monitoring, chronic care management, advanced primary care management, and preventive services. Daniel is also a practicing healthcare attorney specializing in regulatory compliance, reimbursement, scope of practice, and patient care issues.
Daniel Tashnek
Daniel Tashnek, JD, is the co-founder and CEO of Prevounce Health, a healthcare software and services company that simplifies the provision of remote patient monitoring, chronic care management, advanced primary care management, and preventive services. Daniel is also a practicing healthcare attorney specializing in regulatory compliance, reimbursement, scope of practice, and patient care issues.
