; and (ii) the amount (if any) the applicable hospital otherwise receives for direct graduate medical education costs under subsection (h) or section 1814(l), as applicable, with respect to each such resident. (B) Total elective rural sustainability amount (i) Establishment for initial cost reporting periods (I) In general Subject to subclause (II), for cost reporting periods beginning during the first year beginning on or after the date of the enactment of this subsection, the Secretary shall establish a total elective rural sustainability amount for time spent by each full-time-equivalent resident in an approved medical residency training program that receives training in a rural training location. Such amount shall be the amount that the Secretary determines is equal to the median national direct GME training costs per full-time-equivalent resident for 2015 described in table 9 on page 33 of the March 2018 GAO report on Physician Workforce (GAO–18–240), updated for each subsequent year through the first year beginning on or after the date of the enactment of this subsection, by the annual percentage increase in the consumer price index for all urban consumers (all items; United States city average). (II) Application to urban hospitals For cost reporting periods beginning during the first year beginning on or after the date of the enactment of this subsection, in the case of an applicable hospital that is not located in a rural area— (aa) with respect to such residents that receive training in a rural track or an integrated rural track, the total elective rural sustainability amount per resident shall be equal to the amount established under subclause (I)