Sliding Fee Scale Discount Guide for Critical Access Hospitals and Rural Health Clinics

Date: April 26, 2022

Sliding Fee Scale Discount Guide Updated

Updated April 2022, the Sliding Fee Scale Discount Guide provides critical access hospital (CAH) and rural health clinic (RHC) executive and management teams with concepts and guidance in developing a Sliding Fee Scale Discount Program. It also assists in gaining an understanding of how sliding fee scale discount programs relate to Internal Revenue Code Section 501(r) compliance and participation in the National Health Service Corps (NHSC). In addition, the content includes information about:

  • Reasons to implement a sliding fee scale discount program
  • Setting policies
  • Creating a sliding fee scale discount structure
  • Using a sliding fee scale discount in your organization
  • An example of a sliding fee schedule

What is the sliding fee scale discount program?

A sliding fee scale discount program adjusts the amount an eligible patient owes for health care services based on the patient’s ability to pay. Sliding fee scales are a means of addressing the need for equitable access to health services for all individuals.

While the methodology may vary, sliding fees are typically based upon the Federal Poverty Guidelines (FPG) and patient eligibility is determined by annual income and family size. Schedules are established and implemented to ensure that a non-discriminatory, uniform, and reasonable charge is consistently and evenly applied to all qualifying patients.

View the video for more information.