Medical education is recognized as a legitimate cost of doing business in a teaching hospital. This article outlines the general principles and concepts currently used to determine the actual amount of financial reimbursement that a hospital receives for its graduate medical education (GME) programs. Directors of Medical Education should have a solid understanding of these principles if they are to work successfully with the hospital reimbursement experts to maximize the teaching hospital's revenue. To that end, the authors detail 10 rules to ensure that all essential elements are included in the reimbursement formulas. Also considered are the nonfinancial benefits of GME of which hospital leadership must be aware so that they may understand the total contribution that GME makes to the teaching hospital.