The Indian Health Service (IHS) has issued in the attached March 9, 2016, FEDERAL REGISTER notice its Calendar Year (CY) 2016 reimbursement rates applicable to Medicare and Medicaid services provided by IHS-funded health programs (operated by IHS and tribes/tribal organizations). These rates are set annually by IHS, with the concurrence of the Office of Management and Budget, and are based on cost reports compiled by IHS.
Medicare Part A (Inpatient Services) rates are not included in the notice as they are paid based on the prospective payment system. A comparison of the 2015 and 2016 rates follows:
Inpatient Hospital Per Diem Rate (Excludes Physician Services) for MEDICAID
CY 2015 CY 2016
Lower 48 $2,443 $2,655
Alaska $2,926 $3,335
Outpatient Per Visit Rate (Excluding Medicare) for MEDICAID
CY 2015 CY 2016
Lower 48 $350 $368
Alaska $601 $603
Outpatient Per Visit Rate for MEDICARE
CY 2015 CY 2016
Lower 48 $307 $324
Alaska $564 $582
MEDICARE Part B Inpatient Ancillary Per Diem Rate
CY 2015 CY 2016
Lower 48 $516 $ 637
Alaska $956 $1,082
The Outpatient Surgery Rates for Medicare are the established Medicare rates for freestanding Ambulatory Surgery Centers.
