Medicare Claims Processing Manual (Pub. 100-04), Ch. 19 § 100.11
A/B MAC (A) - Pulmonary Rehabilitation, Physical Therapy,
100.11 - A/B MAC (A) - Pulmonary Rehabilitation, Physical Therapy,
Occupational Therapy, Speech-Language Pathology and Diagnostic
Audiology Services - Payment Policy
(Rev. 3897, Issued: 10-27-17, Effective: 01-01-10, Implementation: 04-02-18)
Effective January 1, 2006, IHS providers are paid separately from the AIR for physical
therapy, OT, speech-language pathology and diagnostic audiology services. Payment for
services to IHS providers on TOB 12X or 13X is made based on the MPFS. Payment for
services to IHS CAHs on TOB 85X is made based on reasonable cost.
Effective January 1, 2010, IHS providers are paid separately from the AIR for Pulmonary
Rehabilitation services. Payment for services to IHS providers on TOB 13X is made
based on the MPFS. Payment for services to IHS CAHs on TOB 85X is made based on
reasonable cost.