Develop Workforce Through Recruitment, Training, and Retention
Recruits, trains and keeps rural health workers through apprenticeships, residencies, preceptor incentives and recruitment campaigns, run with the Department of Labor and Industry.
RHTP state profile · Montana
Montana Rural Health Transformation Program
Montana received $233.5 million in Year 1 of the $50 billion federal Rural Health Transformation Program, 4th of 50 states. The Montana Department of Public Health and Human Services (DPHHS) runs the program, which funds five initiatives across Montana's 51 rural counties and the rural parts of its five metro counties, from workforce and EMS to school-based care and health records.
Year 1 awards, all 50 statesMT: $233.5M
Texas $281.3MNew Jersey $147.3M
$233.5MYear 1 award, 4th of 50
5Funded initiatives
51 / 56Montana counties are rural
DPHHSMontana Department of Public Health and Human Services
Spending data in the RHTP Year One Report covers December 29, 2025 to July 31, 2026, the latest CMS reporting window.
At a glance
Montana's program at a glance
The award is fixed for the year. Spending moves every quarter, so Montana's section of the RHTP Year One Report tracks how much was put to work, and with whom, through July 31, 2026. It updates after each CMS data release.
Year 1 award$233,509,358, 4th of 50 states
Run byMontana Department of Public Health and Human Services
Budget Period 1December 29, 2025 to October 30, 2026
Initiatives5
Rural counties51 of 56
Spending data through July 31, 2026Montana's section of the Year One Report →Initiatives
What does Montana's RHTP fund?
Montana's RHTP funds five initiatives across workforce, rural facility sustainability, care and payment models, prevention and health technology. Every grant and contract DPHHS posts maps to one of these five.
Ensure Rural Facility Sustainability and Access Through Partnerships and Restructuring
Creates a time-limited Rural Health Center of Excellence that recommends changes to rural facilities and pays incentives to those that adopt them, plus telehealth and specialist partnerships.
Launch Innovative Care Delivery and Payment Models
Expands value-based payment, modernizes EMS with community paramedicine and equipment, and widens pharmacist services to cut preventable emergency visits.
Invest in Community Health and Preventive Infrastructure
Expands school-based primary, behavioral and dental care with FQHCs and other providers, plus mobile care, tribal health programs and critical facility repairs.
Deploy Modern Health Care Technologies to Guide Rural Health Interventions
Helps rural providers modernize electronic health records and improves shared health data tools such as a statewide bed registry.
Recipients by initiative are in Montana's section of the RHTP Year One Report.
Source documents
Montana's full plan is public
The approved plan has more detail than any summary: goals, partners, metrics and timelines for each initiative. Read it before responding to a Montana grant or RFP.
PDFDPHHSMontana RHT Program PlanThe full plan from DPHHS, including all five initiatives and Montana's policy commitments.PDFDPHHSMontana RHT Project SummaryDPHHS's short overview of the plan.PDFDPHHSMontana RHT Budget NarrativeHow DPHHS plans to spend the award across the five initiatives.PDFCMSCMS 50-State SpotlightsCMS's short profile of each state's program, including Montana's.PDFCMSCMS State Project AbstractsEach state's own summary, side by side.
Rural county (51)Metro counties (5)
Eligibility
Which Montana counties are eligible for RHTP funding?
Montana's program covers the 51 of its 56 counties that HRSA classifies as rural, plus rural census tracts inside the five metro counties: Cascade, Gallatin, Lewis and Clark, Missoula and Yellowstone. By the same definition, 204 of the state's 219 census tracts are rural. DPHHS says eligibility depends on impact on rural residents, not on where an applicant is based, so urban organizations can apply if their rural impact is clear.
How to apply
How can Montana providers apply for RHTP funding?
Montana providers and vendors apply through DPHHS: grants are posted on its RHTP Grants page and submitted through Submittable, and contracts are bid as RFPs on the state's eMACS procurement system. Some workforce funding flows through the Department of Labor and Industry. Providers and vendors don't apply to CMS directly.
- Match the work to an initiative.Funding only goes to work that fits one of the five.
- Watch for new rounds.Sign up for DPHHS RHTP email updates, and check the Grants and Requests for Proposals pages.
- Register in SAM.gov and eMACS.Get a UEI in SAM.gov, then register in eMACS and select commodity code 2620 for RHTP bids.
- Plan for federal rules.Grant recipients follow federal grant, reporting and audit rules. A Single Audit applies at $1 million or more in federal spending a year.
- Ask DPHHS directly.Email HHSRuralHealthTransformation@mt.gov.
Federal terms
Four rules that shape every award
Federal terms follow the money down to every Montana recipient.
Grants and contracts carry different obligations
A subaward makes your organization a subrecipient that carries out part of the program, with federal reporting and audit requirements. A contract pays for goods or services, with lighter requirements.
New rounds follow CMS budget approval
States can't post funding opportunities until CMS approves their budget, so windows can open months into a budget period.
Workforce incentives need a rural commitment
Recruitment and retention payments require clinicians to commit to serving rural communities for at least five years.
Recipients must disclose the federal funding
Under the Stevens Amendment, websites, social posts and other public materials about a funded project must name the federal funding.
Allowable costs
What can Montana's RHTP funding pay for?
Montana's RHTP funding can pay for work on existing facilities, uncovered care, technology and administration, within federal caps on each use. Applied to Montana's Year 1 award, the maximums are:
Capital and infrastructure20% of award
About $46.7M
Provider payments15% of award
About $35.0M
Administrative costs10% of award
About $23.4M
Rural Tech Catalyst Fund10% or $20M, whichever is less
$20.0M
Replacing an existing EMR system5% of award
About $11.7M
Provider payments and capital
Provider payments cover services insurance doesn't pay for, quality bonuses and outcome-based payments tied to Montana's plan. They can't raise rates for services providers already bill.
Capital funds go to existing facilities: renovations, accessibility upgrades, HVAC and like-for-like equipment replacement.
Off limits
- New construction, demolition and major expansions
- Cosmetic work such as painting, carpet or decor
- Clinician salaries at facilities that use non-compete clauses
- Home broadband installation and service
- Costs already covered by other federal or state funding
Policy commitments
Montana's policy commitments carry deadlines
Montana committed to five policy actions in its application. One is done. CMS can reduce or recover funding if the rest slip.
SNAP sugary food restriction
Implement a USDA-approved waiver to exclude soda, candy and junk food from SNAP purchases
USDA approved May 19, 2026; in effect September 30, 2026Nutrition education for physicians
Introduce and enforce a nutrition continuing medical education requirement for physicians
EMS licensure compact
Join the EMS Personnel Licensure Interstate Compact
A Licensing Reform Task Force subcommittee recommends legislation in the next sessionDental hygienist scope of practice
Let dental hygienists diagnose and create treatment plans
Under review by the Licensing Reform Task ForceRemote care payment
Set Medicaid payment for store-and-forward care and remote patient monitoring
Montana already belongs to the physician, nurse, psychology and physician assistant licensure compacts.
Years 2 to 5
$40B
Future awards depend on progress
Year 1 is not a guaranteed annual amount. CMS plans up to $40 billion more nationwide through 2030 and rescores every state each year on progress, data and policy actions.
Unobligated money leaves the state
Funds not obligated by the end of a budget period can't be obligated later and are redistributed to other states.
Funds can be clawed back
CMS can withhold, reduce or recover money for unallowable costs, unapproved plan changes or missed policy commitments. States get 90 days to fix a violation, and most decisions can't be appealed.
Oversight is growing
CMS's Office of Rural Health Transformation plans site visits in all 50 states in 2026. Audits start in 2027.
Method
Reading Montana's spending data
Use the numbers in Montana's section of the RHTP Year One Report to understand direction and pace, not as an audit.
Put to work is not paid out
Obligated money is signed to a contract or grant. Cash reaches recipients later.
Through July 31, 2026 only
The data covers December 29, 2025 to July 31, 2026, as Montana reported it to CMS. Commitments made after July 31, 2026 are not counted yet.
Recipients sit inside line items
The CMS report has no recipient column. Search Montana's line item descriptions by name.
Quarterly refresh
CMS updates the data after each quarterly state report, starting with the November 30, 2026 filing.
Announcements
Major Montana announcements
DPHHS announces $3.63 million for 17 rural EMS agencies to start or expand community integrated health services that bring care into patients' homes.
DPHHS announces $8.7 million for 78 rural EMS agencies for equipment upgrades and four new ambulances.
DPHHS names members of the Center of Excellence Advisory Council, which guides the rural facility sustainability initiative.
USDA approves Montana's waiver to exclude soda, candy and junk food from SNAP purchases, one of the state's RHTP policy commitments.
DPHHS opens proposals for the Center of Excellence strategy and analytics contractor and implementation partner.
CMS awards Montana $233.5 million for Year 1, the fourth-largest award of any state.
Awards announced after July 31, 2026 are not in the CMS spending data yet. They will appear after the next CMS refresh.
Timeline
Key dates
- Dec 29, 2025Year 1 award; Budget Period 1 begins
- May 19, 2026USDA approves Montana's SNAP waiver
- Jul 31, 2026End of the first CMS reporting window; Year One Report spending data runs through this date
- Sep 30, 2026SNAP food restrictions take effect
- Oct 30, 2026Budget Period 1 ends
- Nov 30, 2026Quarterly reports due; CMS refreshes funding data
- 2027End of FY2027 deadline for nutrition education, EMS compact, dental hygienist and remote care commitments
- 2030Final year of the five-year program
Implications
What this means
For rural hospitals
The Center of Excellence is the core of Montana's plan: it will recommend changes at rural facilities and pay one-time incentives to those that adopt them and hit measurable targets. Rural and tribal hospitals, FQHCs and rural health clinics can opt in, so watch the CoE Advisory Council's work and DPHHS announcements.
For partners and vendors
Montana routes much of its money through large prime contracts, such as school-based care and the Center of Excellence, that can pass work to subcontractors with state approval. Listing in the DPHHS Vendor and Subcontractor Directory and registering in eMACS are the first steps. EMS, workforce, school-based care and health records are the most active lanes.
For applicants and grantees
Build tracking for the metrics Montana reports to CMS before an award lands. Subrecipients can't opt out of reporting, and their results feed Montana's annual rescoring.
FAQ
Montana RHTP FAQs
Who runs Montana's Rural Health Transformation Program?
The Montana Department of Public Health and Human Services (DPHHS) runs Montana's Rural Health Transformation Program, using federal funding from the Centers for Medicare & Medicaid Services (CMS). DPHHS manages the state's plan, posts grants and RFPs and answers questions at HHSRuralHealthTransformation@mt.gov. The program is Montana's share of the $50 billion federal Rural Health Transformation Program.
How much RHTP funding did Montana receive?
Montana received $233,509,358 for Year 1 of the Rural Health Transformation Program, 4th of 50 states. Every state got $100 million in baseline funding, and the rest of Montana's award was based on its rural needs, its policy commitments and the strength of its plan. Later years depend on Montana's progress.
Can Montana RHTP funding pay for construction?
No. RHTP funds can't pay for new construction, demolition or major expansions. Up to 20% of Montana's award each year, about $46.7 million in Year 1, can go to work on existing facilities, such as renovations, accessibility upgrades, HVAC replacement and like-for-like equipment replacement.
Can Montana providers use RHTP funding to pay for patient care?
Only for care that insurance doesn't already pay for. Provider payments can cover nonreimbursed services, quality bonuses and outcome-based payments tied to Montana's plan, up to 15% of the award each year, about $35.0 million in Year 1. They can't raise rates for services providers already bill.
Where can I see how Montana is spending its RHTP funding?
The RHTP Year One Report tracks how much of Montana's award was put to work through July 31, 2026, by initiative and recipient, using state-reported data from CMS, and is updated after each CMS data release. Awards announced after July 31, such as $8.7 million in September 2026 for rural EMS equipment and $3.63 million in October 2026 for community integrated health, will appear after the next CMS refresh.
The Alliance
RHT Alliance members serving Montana
These RHT Alliance members serve Montana providers, with support that spans virtual nursing, virtual care, remote monitoring, EHR and health data, diagnostics, patient education and grant writing.
Azalea HealthCloud EHR and billing with AI-assisted charting for rural hospitals and clinics.
CorstrataTelehealth access to board-certified wound, ostomy and continence nurses.
Equum MedicalTelehealth-enabled physician coverage across specialties.
Health Recovery SolutionsRemote patient monitoring and care management at home.
InterSystemsHealth data platforms and interoperability.
Medical Equipment SourceDigital pathology, mobile labs and lab equipment services.
Rural Health Transformation Funding NetworkGrant writing support for RHTP funding opportunities.
Self Care DecisionsEvidence-based triage that directs patients to the right level of care.
Solid StartsInfant feeding guidance and education for families, built by pediatric feeding specialists.
Teledentistry.com24/7 virtual dental evaluations and emergency triage.
VitalChatVirtual nursing and continuous audio and video care across hospitals.
WebMD IgniteMedically reviewed patient education and outreach, including its HEART rural program.Follow Montana's money as it moves
The RHTP Year One Report tracks obligations, initiatives and recipients for all 50 states after each CMS data release.