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Transmittal Notice 80-03

TN 80-03


Under authority of Section 321 o the Public Health Service Act (42 U.S.C. 248(a), the Assistant Secretary for Health and Surgeon General has approved the following reimbursement rates for inpatient and outpatient medical care in facilities operated by Health Services Administration for fiscal year 1980:

Emergency Non-Beneficiaries, Foreign Seafarers, beneficiaries of Other Federal Agencies, Medicare and Medicaid Beneficiaries and Tortiously Liable Third Parties:

Lower Forty-Eight States

FYE September 30, 1980

Inpatient Services per day $196.00 1/
Outpatient Services per visit   41.00
Physical Examination   55.00 2/
Immunization    8.00 3/
Inpatient - Part A - Hospitals 234.00
Inpatient - Part B - Physician   22.00
Total - 11.6 Percent Limitation 256.00
Outpatient - Part B   65.00

1/ The amount billed is the per diem rate indicated less the amount paid by the individual for subsistence, i.e., less $1.60 per day in the case of active duty personnel, and less $5.00 per day in the case of dependents (FY 80).

2/ The physical examination includes all necessary procedures as available, e.g., medical history, dental examination, laboratory tests, x-ray, etc., as many agreed upon between the IHS facility and referring agency.

3/ The charge covers all routine and special examination procedures and services physically available at the station, exclusive of outside consultants' services.  (In the event that hospitalization is necessary in the medical evaluation of the examinee, the reciprocal per diem rate for each day of hospitalization and not the examination rate applies).  No charge is made for diagnostic examinations routinely performed for patients prior to an inpatient admission.

Distribution:  PHS 110-129 Tab d
Date:  October 28, 1980