by Jared Staheli
June 25th, 2015
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.