CMS recognizes several distinct hospital types, each defined by federal law and specific Medicare Conditions of Participation. These categories determine how facilities are licensed, reimbursed, and surveyed. Here are the breakdowns and resources.
Acute Care Hospitals (ACH)
- The most common hospital type.
- Provide inpatient diagnostic, medical, and surgical care.
- Must meet full Medicare hospital Conditions of Participation.
- Can operate multiple inpatient campuses and outpatient departments under one CMS Certification Number (CCN).
Critical Access Hospitals (CAHs)
- Small rural hospitals with special designation.
- Must have ≤25 inpatient beds, maintain 24/7 emergency care, and meet distance requirements.
- Receive cost‑based reimbursement to support rural access.
Psychiatric Hospitals
- Provide inpatient psychiatric services.
- Must meet additional psychiatric‑specific Conditions of Participation beyond standard hospital rules.
- May operate as:
- A psychiatric hospital, or
- A Distinct Part Psychiatric Unit within a general hospital.
- Inpatient Psychiatric Facility PPS
Rehabilitation Hospitals / Inpatient Rehabilitation Facilities (IRFs)
- Provide intensive rehabilitation services (e.g., stroke, spinal cord injury).
- Must meet the “60% rule” (majority of patients require intensive rehab).
- Certified under separate IRF Conditions of Participation. (Referenced in CMS provider classifications.)
Long‑Term Care Hospitals (LTCHs)
- Treat medically complex patients requiring extended inpatient stays (average ≥25 days).
- Paid under the LTCH Prospective Payment System. (Included in CMS hospital provider categories.)
Rural Emergency Hospitals (REHs)
- New provider type (effective 2023).
- Designed for rural hospitals that cannot sustain inpatient services.
- Provide 24/7 emergency, outpatient, and observation care only.
- Receive:
- 5% increase in outpatient payments
- Monthly facility payment (CMS fact sheet covers this model.)
Children’s Hospitals
- Specialize in pediatric inpatient care.
- Exempt from certain Medicare payment rules (e.g., DRG system).
- Included in CMS hospital classifications.
Teaching Hospitals
- Affiliated with medical schools.
- Receive Graduate Medical Education (GME) payments.
- Recognized as a CMS hospital subtype.