# Rural Health Transformation Program - Notice of Funding Opportunity (CMS-RHT-26-001) Federal Notice of Funding Opportunity for the Rural Health Transformation Program (RHTP). The RHTP is a one-time $50 billion cooperative agreement program seeking applications from the 50 U.S. states for rural health system transformation, spanning five budget periods (2026–2030). States will develop and implement plans to improve rural healthcare access, quality, and outcomes by supporting evidence-based care delivery models, workforce development, quality improvement, and technology enhancement. Applications must outline a Rural Health Transformation Plan targeting strategic goals including prevention and chronic disease management, sustainable access to care, workforce retention, innovative models, and technology adoption. States must propose use of funds in at least three program-permitted categories and document broad stakeholder engagement. Only single-state applications endorsed by the governor (or designee) are accepted. Funds are distributed with half allocated equally to all approved states and half based on application quality and state rural context. Applications were due by November 5, 2025. ## Key facts - Status: Closed - Type: NOFO - Issued by: Centers for Medicare & Medicaid Services (CMS) (Federal) - Posted: 2025-09-15 - Letter of intent due: 2025-09-30 - Application due: 2025-11-05 - Funding: $50.00B - Eligible applicants: STATE_GOVERNMENT - How to apply: Electronic submission via Grants.gov. Applicants must ensure active SAM.gov and Grants.gov registrations. - Funding source: Rural Health Transformation Program (CMS) - Official source: https://www.cms.gov/priorities/cms-innovation-center/cms-rht/opportunity-application ## Requirements Applications must include: a governor-signed letter of endorsement; a Rural Health Transformation Plan addressing required priority areas; descriptions of proposed initiatives aligned with at least three eligible uses of funds; a stakeholder engagement framework; an implementation plan and timeline; and a performance measurement and evaluation plan with defined metrics. Applications must comply with federal formatting, registration, and submission requirements (SAM.gov and Grants.gov). Only applications submitted by the deadline are accepted. Additional requirements include budget narrative, demonstration of stakeholder engagement, and compliance with all cooperative agreement terms. ## Required attachments - Governor endorsement letter - State Rural Health Transformation Plan - Stakeholder engagement framework - Implementation plan with timeline - Performance measurement and evaluation plan - Budget narrative ## Application package and source documents - [US - 2026 - Notice of Funding Opportunity: RHTP (CMS-RHT-26-001)](https://www.ruralcarejourney.com/api/documents/b254e0cb-f563-423d-9aab-70fea64f1421/file) — official: https://crh.arizona.edu/sites/default/files/2025-09/250915_Rural-Health-Transformation-Program_NOFO.pdf - [US - 2025 - Notice of Funding Opportunity Application due November 5, 2025 RHTP Opportunity number: CMS-RHT-26-001 (Idaho-hosted copy of national NOFO (CMS-RHT-26-001))](https://www.ruralcarejourney.com/api/documents/2f246663-e6f9-44cd-baa9-2ed6283b0d0a/file) — official: https://publicdocuments.dhw.idaho.gov/WebLink/ElectronicFile.aspx?docid=37370&dbid=0&repo=PUBLIC-DOCUMENTS - [US - 2025 - RHTP — Notice of Funding Opportunity (SHVS regulatory analysis of the NOFO (duplicate URL variant))](https://www.ruralcarejourney.com/api/documents/47435b8c-b08f-4b19-9631-3797ba29cef3/file) — official: https://shvs.org/resource/cms-releases-rural-health-transformation-funding-opportunity/ - [US - 2025 - State Level RFI Tracking – RHT Fund (NRHA state-level RFI tracking)](https://www.ruralcarejourney.com/api/documents/f161b9cb-0d9b-454e-82ff-c1cfcaddf6fb/file) — official: https://www.ruralhealth.us/nationalruralhealth/media/documents/advocacy/2025/state-level-rfi-tracking-%E2%80%93-rural-health-transformation-fund-10-23-25.pdf - [US - 2025 - RHTP Notice of Funding Opportunity for State Policy Agendas (NRHA NOFO guide for state policy agendas)](https://www.ruralcarejourney.com/api/documents/1a626e16-6b94-4791-922a-09007bf76604/file) — official: https://www.ruralhealth.us/NationalRuralHealth/media/Documents/Advocacy/2025/State-Related-Policy-RHTP-Guide.pdf - [US - 2025 - RHTP Notice of Funding Opportunity (NRHA NOFO summary)](https://www.ruralcarejourney.com/api/documents/2432637b-1cfa-4930-a068-403cdce2062a/file) — official: https://nrha-prod-eastus-be.azure.silvertech.net/NationalRuralHealth/media/Documents/Advocacy/2025/RHTP-NOFO-summary-9-16-25.pdf - [US - 2026 - NRHA Statement on the RHTP NOFO (NRHA statement on NOFO release)](https://www.ruralcarejourney.com/api/documents/7ed6a52a-9459-46bb-a3f9-a75ade33d9a3/file) — official: https://www.ruralhealth.us/blogs/2025/09/nrha-statement-on-the-rural-health-transformation-program-nofo - [US - 2025 - NRHA RHT Fund Program Summary (NRHA RHT Fund legislative summary)](https://www.ruralcarejourney.com/api/documents/b9d7bbab-b479-4cb1-a414-f78c1df56893/file) — official: https://www.ruralhealth.us/programs/center-for-rural-health-innovation-and-system-redesign/rural-health-transformation-program/rhtp-legislative-resources - [US - 2025 - Notice of Funding Opportunity for the RHTP (SHVS regulatory analysis of the NOFO)](https://www.ruralcarejourney.com/api/documents/0a45a1ac-762b-4c15-95f8-5573d5138d60/file) — official: https://shvs.org/resources/cms-releases-rural-health-transformation-funding-opportunity/ - [US - 2026 - CMS RHTP](https://www.ruralcarejourney.com/api/documents/e04c82f9-6d26-4d92-8db9-7715c2a38d4a/file) (primary) — official: https://www.cms.gov/files/document/rural-health-transformation-50-state-spotlights.pdf More Federal RHTP activity: https://www.ruralcarejourney.com/states/us (markdown: https://www.ruralcarejourney.com/states/us.md) --- Source: Rural Care Journey (RCJ), https://www.ruralcarejourney.com/opportunities/rural-health-transformation-program-notice-of-funding-opportunity-cms-rht-26-001--181779b5d6 — data as of 2026-09-12. Cite the RCJ page for the summary and the linked official source for authoritative terms, deadlines, and amounts.