Indian Health Service Issues Reimbursement Rates for Calendar Year 2011

The Indian Health Service has issued its Calendar Year (CY) 2011 reimbursement rates applicable to Medicare and Medicaid services provided by Indian Health Service-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. The 2011 rates were published in the attached May 2, 2011, FEDERAL REGISTER notice.

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 2010 and 2011 rates follows:

Inpatient Hospital Per Diem Rate (Excludes Physician Services) for MEDICAID
CY 2010CY 2011
Lower 48$2,046$2,034
Outpatient Per Visit Rate (Excluding Medicare) for MEDICAID
CY 2010CY 2011
Lower 48$289$294
Outpatient Per Visit Rate for MEDICARE
CY 2010CY 2011
Lower 48$246$256
MEDICARE Part B Inpatient Ancillary Per Diem Rate
CY 2010CY 2011
Lower 48$429$443

The Outpatient Surgery Rates for Medicare are the established Medicare rates for freestanding Ambulatory Surgery Centers.