A/B MAC (A) - Outpatient - Medicare Part B - Payment Policy

100.5 - A/B MAC (A) - Outpatient - Medicare Part B - Payment Policy (Rev. 1511; Issued: 05-23-08; Effective: 01-01-08; Implementation: 06-23-08) The IHS providers are paid for covered outpatient services based upon an all inclusive outpatient per visit rate (AIR). The AIR is established by CMS and IHS based upon a review of yearly cost reports prepared by IHS’s contractor. Upon completion of the review, IHS submits the agreed upon rate to OMB for approval. Upon approval by OMB, IHS publishes the approved rate in the Federal Register. The AIR is established for each calendar year. The approved AIR is issued periodically in a Recurring Update Notification. Medicare Part B deductible and coinsurance amounts are applied to outpatient services, but are waived by the IHS. These rates are not all inclusive inpatient ancillary per diem rates and should not be confused with the all-inclusive inpatient ancillary per diem rates paid to IHS providers for services covered under Medicare Part B when coverage is no longer provided under Medicare Part A. For more information on the all-inclusive inpatient ancillary per diem rates, see §100.3.4 of this chapter.