by Jared Staheli
June 25th, 2015
Effective January 1, 2006, IHS providers are paid separately from the AIR for physical therapy, OT, speech-language pathology and diagnostic audiology services. Payment for services to IHS providers on TOB 12X, 13X or 83X is made based on the MPFS. Payment for services to IHS CAHs on TOB 85X is made based on reasonable cost.
The Medicare Part B deductible and coinsurance apply to therapy services and diagnostic audiology services, but are waived by the IHS.
NOTE: Effective for dates of service on or after January 1, 2008, the FI no longer processes claims for IHS ASCs (TOB 83X). All IHS ASC providers must submit their claims to the carrier.