IHS Boosts 2026 Reimbursement Rates for Tribal Healthcare Services
Published Date: 1/22/2026
Notice
Summary
Starting in 2026, the Indian Health Service is updating how much it pays for hospital and clinic visits for Medicare, Medicaid, and other federal program patients. Inpatient and outpatient rates are set higher for both the Lower 48 States and Alaska, with special add-ons for costly drugs at IHS and Tribal hospitals. These changes mean better support for medical care costs, kicking in January 1, 2026.
Analyzed Economic Effects
6 provisions identified: 6 benefits, 0 costs, 0 mixed.
Inpatient Per Diem Rates Set
If you receive inpatient care at an Indian Health Service (IHS) facility and are a Medicare or Medicaid beneficiary, the per diem rates for Calendar Year 2026 are $5,707 for the Lower 48 States and $5,208 for Alaska. These rates exclude physician and practitioner services and are effective for services on or after January 1, 2026.
Outpatient Per-Visit Rates (Non‑Medicare)
For Calendar Year 2026, the IHS outpatient per-visit rate excluding Medicare is $826 for the Lower 48 States and $1,222 for Alaska. These rates apply to outpatient visits provided on or after January 1, 2026.
Outpatient Per-Visit Rates (Medicare)
For Calendar Year 2026, the IHS outpatient per-visit rate for Medicare is $733 for the Lower 48 States and $1,233 for Alaska. These Medicare outpatient rates are effective for services on or after January 1, 2026.
Medicare Part B Inpatient Ancillary Rate
For Calendar Year 2026, the Medicare Part B inpatient ancillary per diem rate at IHS facilities is $1,289 for the Lower 48 States and $1,617 for Alaska. These rates apply to services on or after January 1, 2026.
CMS Add‑On for High‑Cost Drugs Continued
CMS will continue to pay an add-on to the Medicare outpatient per-visit rate for certain high-cost drugs administered at IHS or Tribal hospitals for Calendar Year 2026 (see 90 FR 53448, November 25, 2025). The qualifying high-cost drugs for 2026 are listed in Addendum Q to that CMS Final Rule.
Outpatient Surgery Rate Note
The notice states established Medicare rates apply for outpatient surgery at freestanding Ambulatory Surgical Centers for Calendar Year 2026. These apply to services on or after January 1, 2026.
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Key Dates
Department and Agencies
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