Rural Health Transformation Program funds can pay for a wide range of rural care projects: workforce recruitment and retention, telehealth, care coordination, health information technology, and new access points, including mobile health units. The program sends $50 billion to states over five years, and each state decides which projects to fund under the plan it submitted to CMS. So the practical answer to "what can this money pay for" depends on two things: the federal list of allowable uses, and what your state wrote into its approved plan. This post covers both, and what it means for the projects you are trying to fund.
The Rural Health Transformation Program is a $50 billion federal fund created by Section 71401 of Public Law 119-21 to improve access, quality, and outcomes in rural communities. CMS runs it through a new Office of Rural Health Transformation, and the money flows to states, not directly to providers.
The funding runs across five federal fiscal years, FY2026 through FY2030, at $10 billion a year. Half is split equally among all approved states; the other half is distributed by formula, based on each state's rural population, the shape of its rural health system, and the strength of the projects in its application. All 50 states applied and all 50 were approved, with first-year awards averaging about $200 million and ranging from $147 million to $281 million per state. You can read the program details on the CMS RHT overview page.
CMS set out broad categories of allowable use, and states built their plans inside them. The common ones include:
The through-line is prevention and access: CMS has framed the program around evidence-based projects that manage chronic disease, expand behavioral and prenatal care, and keep rural providers viable as long-term access points. States have real flexibility inside those categories, which is why allowable activities vary from one state to the next. For a grantwriter, that means the federal list tells you what is possible, and the state plan tells you what is fundable where you work. A useful outside summary of the categories is PYA's provider guide to the program.
Yes. The Notice of Funding Opportunity named mobile health as an allowable use, tied to population health infrastructure, rural health networks, and remote or non-clinic care. Georgetown's Center on Health Insurance Reforms found that at least 42 states referenced mobile health in their plans, often as a way to deliver preventive, maternal, chronic disease, and dental care in places without a fixed site (see the CHIR analysis of mobile health in state RHT plans).
The caution for anyone building a mobile project: naming mobile health in a plan is not the same as funding it well. Many state plans mention mobile units without specifying how they will be staffed, integrated into referral networks, or sustained past the initial purchase. If you are writing a mobile project into a state proposal or a subgrant, the operating plan is where proposals win or lose. A well-run program needs planning and staffing, workflows, and a maintenance model, not just a vehicle.
Your state does. CMS awarded the money to states, and each state administers its own plan, including how it distributes funds to providers, health centers, and community organizations. In practice, most states will pass money through as subgrants or contracts under the projects named in their application.
That makes the state office running the program your first stop. Find your state's RHT plan and its lead agency (often the state office of rural health, Medicaid agency, or a dedicated program office), read the funded project categories, and match your proposal to what the state actually committed to. A project that fits a named plan initiative has a far shorter path than one that asks the state to fund something outside its approved scope.
RHT funds are meant to transform delivery, not to backfill routine operating deficits. The program is built around projects with measurable outcomes, so general operating support, debt relief, or spending unconnected to a funded project category is a weak fit. CMS has emphasized outcomes-driven, evidence-based interventions and long-term sustainability, which means reviewers expect a project to show what it will change and how it will keep running.
There is also a hard clock. Funding runs through FY2030, so any project should carry a plan for what happens when the RHT dollars end. Building sustainment into the proposal from the start is now part of writing a competitive rural health project.
First-year awards averaged about $200 million per state, ranging from $147 million to $281 million. The total program is $50 billion over five years, at $10 billion a year from FY2026 through FY2030, split half equally among states and half by formula.
No. CMS awarded the funds to states. Providers, health centers, and community organizations access the money through their state's plan, usually as subgrants or contracts. Your first step is your state's RHT lead agency, not CMS.
Yes. The Notice of Funding Opportunity named mobile health as an allowable use for population health, rural networks, and remote care, and at least 42 states referenced it in their plans. Whether it is funded where you work depends on your state's approved plan.
The program runs through federal fiscal year 2030. Proposals should include a plan for sustaining the work after RHT dollars run out, since reviewers weigh long-term viability.
Start with the CMS RHT overview page and your state's office of rural health or Medicaid agency, which administers the plan and its funding decisions.
If you are shaping a rural project and want to know whether it fits your state's plan, talk with our team. We help program leaders turn an RHT opportunity into a program that runs and lasts.