The Rural Health Transformation Program (RHTP) is a $50 billion federal program, created by Section 71401 of Public Law 119-21 (the One Big Beautiful Bill Act), that CMS distributes to states over five fiscal years, FY2026 through FY2030, at $10 billion a year.
All 50 states received first-year awards in late December 2025, averaging about $200 million each. States, not hospitals, hold the awards and pass funds to rural hospitals, clinics and other partners through subawards and contracts.
By Jack Risenhoover, HealthRoots.ai · Last updated: October 16, 2026
| Item | What the sources say |
|---|---|
| Legal basis | Section 71401 of Public Law 119-21, which amends Section 2105 of the Social Security Act (Public Law 119-21, Section 71401 (statutory text, CMS); CMS). |
| Total funding | $50 billion, $10 billion available each fiscal year, FY2026 through FY2030 (CMS). |
| How it is split | 50% distributed equally among approved states ("baseline"); 50% allocated by CMS ("workload") based on rural population, rural facilities, state policy actions and the state's initiatives (CMS press release; CMS Notice of Funding Opportunity CMS-RHT-26-001 (via Grants.gov)). |
| Who can apply | Only the 50 states. D.C. and territories are not eligible. Hospitals, clinics, tribes and others cannot apply directly but may take part through subawards or partnerships (CMS; CMS). |
| Year 1 awards | Announced by CMS in December 2025: all 50 states funded, ranging from about $147 million (New Jersey) to about $281 million (Texas). Oklahoma received $223,476,949 (CMS press release; The White House). |
| Spending window | For each budget period, states have until the end of the following federal fiscal year to spend the money (CMS Notice of Funding Opportunity CMS-RHT-26-001 (via Grants.gov)). |
States must spend on at least three of the permissible uses in the statute (CMS):
Year 1 ($10 billion) has been awarded and states are scoping projects and making subawards. Under the funding notice, CMS sets FY2027 (Year 2) award amounts by October 31, 2026, after reviewing each state's annual progress report and continuation application (CMS Notice of Funding Opportunity CMS-RHT-26-001 (via Grants.gov)). For rural providers, that means compliance and documentation on Year 1 money now matters for what comes next.
Congress, in Section 71401 of Public Law 119-21 (the One Big Beautiful Bill Act), signed in July 2025. CMS administers it.
$50 billion over five fiscal years, FY2026 through FY2030, with $10 billion available each year.
No. Only states can apply to CMS. Hospitals, CAHs, FQHCs and other organizations participate through state subawards, grants or contracts.
HealthRoots.ai offers one RHTP Grant Compliance, Auditing, Analytics & Reporting package for rural hospitals, critical access hospitals and FQHCs that receive RHTP dollars. We help you understand exactly what your award requires and keep you on track. The package includes mock grant reviews. It is priced by quote, based on your scope, your state and how often you have to report.
For other funded grant initiatives, HealthRoots works on a gainsharing basis, with no upfront cost and no IT project. Lifetime patient engagement is delivered with our partner Velocity Health.
Get your free readiness check, or reach us at Curious@Velocity.Health or 940.395.5623.
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HealthRoots.ai is independent and is not affiliated with or endorsed by CMS or any state agency. This page is general information, not legal advice; always confirm requirements in your own award documents and with your state RHTP office.
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