GM 14-026

Indian Health Service Issues Reimbursement Rates for Calendar Year 2014

The Indian Health Service (IHS) has issued in the attached April 8, 2014, FEDERAL REGISTER notice its Calendar Year (CY) 2014 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 2013 and 2014 rates follows:
Inpatient Hospital Per Diem Rate (Excludes Physician Services) for MEDICAID
CY 2013 CY 2014
Lower 48 $2,271 $2,413
Alaska $2,591 $2,675

Outpatient Per Visit Rate (Excluding Medicare) for MEDICAID
CY 2013 CY 2014
Lower 48 $330 $342
Alaska $541 $564

Outpatient Per Visit Rate for MEDICARE
CY 2013 CY 2014
Lower 48 $283 $297
Alaska $515 $576

MEDICARE Part B Inpatient Ancillary Per Diem Rate
CY 2013 CY 2014
Lower 48 $483 $502
Alaska $846 $862

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