Medicare Claims Processing Manual (Pub. 100-04), Ch. 19 § 30
Medicare Part B Services
30 - Medicare Part B Services
(Rev. 2075, Issued: 10-28-10, Effective: 01-01-10, Implementation: 01-28-11)
Effective July 1, 2001, §432 BIPA extended payment for the services of physician and
non-physician practitioners furnished in hospitals and ambulatory care clinics (services
paid under the MPFS, §1848 of the Act). Clinics associated with hospitals or which are
freestanding that are owned and operated by IHS or tribally owned and IHS operated are
considered to be IHS and are authorized to bill only the designated A/B MAC (B) for
Medicare Part B (medical insurance) services identified in §432 of BIPA 2000. Other
clinics associated with hospitals or which are freestanding that are not considered to be
IHS (i.e., IHS owned but tribally operated or tribally owned and operated) can continue
to bill the local A/B MAC (B) for the full range of covered Medicare services, not
restricted to the limitations of the BIPA provision.
• Prior to enactment of §630 of the MMA of 2003, IHS facilities were not allowed
to bill for Medicare Part B services, other than those paid under the MPFS, which
were covered under §1848 of the Act. Section 630 of the MMA, indefinitely
extended by §2902 of the ACA, expanded the scope of items and services for
which payment may be made to IHS facilities to include all other Medicare Part B
covered items and services beginning January 1, 2005.