CMS Pub. 100-04, ch. 19, § 100.9

Policy

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

The IHS CAHs are paid for covered outpatient services based on 101 percent of an all

inclusive facility specific per visit rate that is established on a yearly basis from prior year

cost report information for both facilities electing Standard Method I and Optional

Method II billing.

For services provided in IHS CAHs, deductible and coinsurance amounts are applied by

Medicare, but are waived by the IHS. Third party payers may be billed for applicable

deductible and coinsurance amounts.

See Chapter 4, §§250.1 and 250.2 of Pub. 100-04, Medicare Claims Processing Manual,

for more information on the payment of Method I and II CAH outpatient claims.

See §§100.10 and 100.11 of this chapter, for more information on the payment of

vaccines and their administration and therapeutic services.