CMS Pub. 100-04, ch. 19, § 100.2

Inclusive Rate (AIR)

(Rev. 1040, Issued: 08-25-06, Effective: 09-11-06, Implementation: 09-11-06)

Unless otherwise specified in this chapter, payment to IHS providers is made based on

the AIR. To understand how payment is made for IHS services, it is recommended that

Chapter 19 be reviewed in its entirety. Services provided in IHS providers that are

considered part of the AIR include:

• Diagnostic tests (see §1861(s)(3)), covered drugs and biologicals furnished

incident to a physician service (see §1861(s)(2)(A) and (b)) and DSMT services

(see 1861(s)(2)(S)).

• Services furnished by a RD or nutrition professional (meeting certain

requirements) as defined in §105 of BIPA for MNT services for beneficiaries with

diabetes or renal disease. (These health care professionals must reassign their

benefits to the hospital or hospital-based clinic.)

• The technical component of screening mammography services, and other

radiological services.

• If the IHS provider purchases laboratory services from another entity, that entity

bills the hospital. The hospital bills Medicare and is paid based on the AIR.

NOTE: This is not an all-inclusive list of services paid under the AIR.