Rural Access to Primary and Preventive Services (RAPPS) Program

The Rural Access to Primary and Preventive Services program is one of four directed payment programs (DPPs) HHSC submitted to the Centers for Medicare and Medicaid Services (CMS) for approval as part of the Delivery System Reform Incentive Payment Transition Plan. CMS approved RAPPS for state fiscal year (SFY) 2022 (Year [Y]1) on March 25, 2022. CMS approved RAPPS for SFY 2023 (Y2) on August 1, 2022.


RAPPS is a DPP for rural health clinics (RHCs) that incentivizes the provision of primary and preventive services to individuals enrolled in the STAR, STAR+PLUS, and STAR Kids Medicaid managed care programs.

The program includes two components:

  • Component 1 provides a uniform dollar increase in the form of prospective, monthly payments to all participating RHCs. The amount of the increase varies by RHC class. Component 1 structure measures include reporting on electronic health record use, telemedicine/ telehealth capabilities, and ensuring access to care for Medicaid clients.
  • Component 2 is a uniform percent rate increase for certain services to incentivize preventive care and services to manage individuals' chronic conditions.

Proposed SFY 2024 (Y3) Measures and Requirements

HHSC will conduct an online public hearing on January 12, 2023, at 10:00 a.m. CST to receive public comment on proposed quality measures and reporting requirements for SFY 2024 (Y3) of RAPPS. Additional information on the hearing is available on the HHS Meetings & Events Page.

This hearing will be conducted online only and will not have a physical location. Please register for this hearing.

Briefing Packet

Written Public Comments

Submit written comments regarding the proposed quality measures and reporting requirements until 11:59 p.m. on January 27, 2023.

SFY 2023 (Y2) Measures, Requirements, and Evaluation

SFY 2022 (Y1) Measures, Requirements, and Evaluation


Contact Information


DPP Contact Change Form (PDF)