GM 18-002

Indian Health Service Issues Reimbursement Rates for Calendar Year 2018

The Indian Health Service (IHS) issued in a January 5, 2018, FEDERAL REGISTER notice its Calendar Year (CY) 2018 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. The notice may be found here:

https://www.gpo.gov/fdsys/pkg/FR-2018-01-05/pdf/2018-00047.pdf

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 2017 and 2018 rates follows:

Inpatient Hospital Per Diem Rate (Excludes Physician Services) for MEDICAID
CY 2017 CY 2018
Lower 48 $2,933 $3,229
Alaska $3,235 $3,277

Outpatient Per Visit Rate (Excluding Medicare) for MEDICAID
CY 2017 CY 2018
Lower 48 $391 $427
Alaska $616 $653

Outpatient Per Visit Rate for MEDICARE
CY 2017 CY 2018
Lower 48 $349 $383
Alaska $577 $595

MEDICARE Part B Inpatient Ancillary Per Diem Rate
CY 2017 CY 2018
Lower 48 $ 679 $ 740
Alaska $1,046 $1,061

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