The Indian Health Service has issued its Calendar Year (CY) 2012 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 2012 rates were published in the attached June 6, 2012, 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 2011 and 2012 rates follows:
Inpatient Hospital Per Diem Rate (Excludes Physician Services) for MEDICAID
CY 2011 CY 2012
Lower 48 $2,034 $2,169
Alaska $2,269 $2,350
Outpatient Per Visit Rate (Excluding Medicare) for MEDICAID
CY 2011 CY 2012
Lower 48 $294 $317
Alaska $490 $515
Outpatient Per Visit Rate for MEDICARE
CY 2011 CY 2012
Lower 48 $256 $273
Alaska $447 $468
MEDICARE Part B Inpatient Ancillary Per Diem Rate
CY 2011 CY 2012
Lower 48 $443 $477
Alaska $756 $811
The Outpatient Surgery Rates for Medicare are the established Medicare rates for freestanding Ambulatory Surgery Centers.
