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CMS Issues FAQs on New GME Slots

Shahid Zaman
March 1, 2022

In new FAQs, the Centers for Medicare & Medicaid Services (CMS) addresses questions on the application process for 1,000 new graduate medical education (GME) slots created by the Consolidated Appropriations Act (CAA) of 2021. CMS plans to award 200 slots annually — with a maximum of five slots to each applicant — to teaching hospitals that meet one of four categories of eligibility:

  • geographically rural hospitals and urban hospitals that reclassified to rural;
  • hospitals training over their Medicare cap;
  • hospitals in states with new residency programs or additional locations and branches of existing medical schools (35 states and Puerto Rico qualify under this definition); and
  • hospitals that serve health professional shortage areas (HPSAs).

In the FAQs, CMS provides additional information on the application timeline, the application process, and eligibility. Applications for the first round of slots are due March 31, 2022, and CMS intends to award slots July 1, 2023. While applications must be submitted through an online portal, CMS provides a link to the application questions in PDF format for applicants to review in advance. CMS also notes the slots cannot be used to fund existing positions hospitals are funding over their GME cap.

In previous rulemaking, CMS stated it will prioritize applications for slots for which at least 50 percent of the residents’ training time will occur in a population or geographic HPSA at program training sites, including nonprovider settings, such as Department of Veterans Affairs facilities. CMS provides additional guidance on the use of HPSAs for eligibility and for prioritization of applications, clarifying:

  • population or geographic HPSAs can be used for prioritization of an application but only geographic HPSAs can be used for determining eligibility;
  • multiple HPSAs cannot be combined to meet the 50 percent prioritization criteria;
  • the 50 percent prioritization criteria apply to an entire residency program and not to each individual resident; and
  • the hospital itself does not have to be in an HPSA, as long as an eligible training site is located in an HPSA.

Contact Director of Policy Rob Nelb, MPH, at or 202.585.0127 with questions.

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