GM 13-034

Indian Health Service Issues Reimbursement Rates for Calendar Year 2013

The Indian Health Service (IHS) has issued in the attached April 17, 2013, FEDERAL REGISTER notice its Calendar Year (CY) 2013 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 2012 and 2013 rates follows:

Inpatient Hospital Per Diem Rate (Excludes Physician Services) for MEDICAID
CY 2012 CY 2013
Lower 48 $2,169 $2,272
Alaska $2,350 $2,591

Outpatient Per Visit Rate (Excluding Medicare) for MEDICAID
CY 2012 CY 2013
Lower 48 $317 $330
Alaska $515 $541

Outpatient Per Visit Rate for MEDICARE
CY 2012 CY 2013
Lower 48 $273 $283
Alaska $468 $515

MEDICARE Part B Inpatient Ancillary Per Diem Rate
CY 2012 CY 2013
Lower 48 $477 $483
Alaska $811 $846

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