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[Federal Register Volume 89, Number 241 (Monday, December 16, 2024)]
[Notices]
[Pages 101607-101608]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-29505]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service

RIN 0917-AA25

Reimbursement Rates for Calendar Year 2025

AGENCY: Indian Health Service, HHS.

ACTION: Notice.

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SUMMARY: Notice is provided that the Director of the Indian Health 
Service (IHS) has approved the rates for inpatient and outpatient 
medical care provided by the IHS facilities for Calendar Year 2025.

SUPPLEMENTARY INFORMATION:

Background

    The Director of the Indian Health Service, under the authority of 
sections 321(a) and 322(b) of the Public Health Service Act (42 U.S.C. 
248 and 249(b)), Public Law 83-568 (42 U.S.C. 2001(a)), and the Indian 
Health Care Improvement Act (25 U.S.C. 1601 et seq.), has approved the 
following rates for inpatient and outpatient medical care provided by 
IHS facilities for Calendar Year 2025 for Medicare and Medicaid 
beneficiaries, beneficiaries of other Federal programs, and for 
recoveries under the Federal Medical Care Recovery Act (42 U.S.C. 2651-
2653). The inpatient rates for Medicare Part A are excluded from the 
table below. That is because Medicare inpatient payments for IHS 
hospital facilities are made based on the prospective payment system, 
or (when IHS facilities are designated as Medicare Critical Access 
Hospitals) on a reasonable cost basis. Since the inpatient per diem 
rates set forth below do not include all physician services and 
practitioner services, additional payment shall be available to the 
extent that those services are provided.
    Please note that the Centers for Medicare and Medicaid Services 
(CMS) has issued a Final Rule to pay an add-on to the Medicare 
Outpatient Per Visit Rate listed below for certain high-cost drugs for 
people with Medicare who receive care at IHS or Tribal hospitals. See 
89 FR 93912, (November 27, 2024), also available at https://www.federalregister.gov/documents/2024/11/27/2024-25521/medicare-and-medicaid-programs-hospital-outpatient-prospective-payment-and-ambulatory-surgical. Further information regarding this proposal will 
be issued directly from CMS.

Inpatient Hospital Per Diem Rate (Excludes Physician/Practitioner 
Services)

Calendar Year 2025
    Lower 48 States: $5,580.
    Alaska: $5,074.

Outpatient Per Visit Rate (Excluding Medicare)

Calendar Year 2025
    Lower 48 States: $801.
    Alaska: $1,209.

Outpatient Per Visit Rate (Medicare)

Calendar Year 2025
    Lower 48 States: $718.

[[Page 101608]]

    Alaska: $1,193.

Medicare Part B Inpatient Ancillary Per Diem Rate

Calendar Year 2025
    Lower 48 States: $1,074.
    Alaska: $1,567.

Outpatient Surgery Rate (Medicare)

    Established Medicare rates for freestanding Ambulatory Surgery 
Centers.
Effective Date for Calendar Year 2025 Rates
    Consistent with previous annual rate revisions, the Calendar Year 
2025 rates will be effective for services provided on or after January 
1, 2025, to the extent consistent with payment authorities, including 
the applicable Medicaid State plan.

Roselyn Tso,
Director, Indian Health Service.
[FR Doc. 2024-29505 Filed 12-13-24; 8:45 am]
BILLING CODE 4166-14-P
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