Notice2026-01178

Reimbursement Rates for Calendar Year 2026

Primary source

Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.

Published
January 22, 2026

Issuing agencies

Health and Human Services DepartmentIndian Health Service

Abstract

Notice is provided that the Chief of Staff, who has the Delegated Authority of the Indian Health Service (IHS) Director has approved the rates for inpatient and outpatient medical care provided by the IHS facilities for Calendar Year 2026.

Full Text

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<title>Federal Register, Volume 91 Issue 14 (Thursday, January 22, 2026)</title>
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[Federal Register Volume 91, Number 14 (Thursday, January 22, 2026)]
[Notices]
[Page 2787]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-01178]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service

RIN 0917-AA26


Reimbursement Rates for Calendar Year 2026

AGENCY: Indian Health Service, HHS.

ACTION: Notice.

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SUMMARY: Notice is provided that the Chief of Staff, who has the 
Delegated Authority of the Indian Health Service (IHS) Director has 
approved the rates for inpatient and outpatient medical care provided 
by the IHS facilities for Calendar Year 2026.

SUPPLEMENTARY INFORMATION:

Background

    The Chief of Staff, who has the Delegated Authority of the Indian 
Health Service (IHS) Director, under the authority of sections 321(a) 
and 322(b) of the Public Health Service Act (42 U.S.C. 248 and 249(b)), 
Public Law 83-568 (42 U.S.C. 2001(a)), and the Indian Health Care 
Improvement Act (25 U.S.C. 1601 et seq.), has approved the following 
rates for inpatient and outpatient medical care provided by IHS 
facilities for Calendar Year 2026 for Medicare and Medicaid 
beneficiaries, beneficiaries of other Federal programs, and for 
recoveries under the Federal Medical Care Recovery Act (42 U.S.C. 2651-
2653). The inpatient rates for Medicare Part A are excluded from the 
table below. That is because Medicare inpatient payments for IHS 
hospital facilities are made based on the prospective payment system, 
or (when IHS facilities are designated as Medicare Critical Access 
Hospitals) on a reasonable cost basis. Since the inpatient per diem 
rates set forth below do not include all physician services and 
practitioner services, additional payment shall be available to the 
extent that those services are provided.
    Please note that the Centers for Medicare & Medicaid Services (CMS) 
has issued a Final Rule to continue to pay an add-on to the Medicare 
Outpatient Per Visit Rate listed below for certain high-cost drugs for 
people with Medicare who receive care at IHS or Tribal hospitals for CY 
2026. See 90 FR 53448, (November 25, 2025). The high-cost drugs 
qualifying for this add-on payment for CY 2026 are listed in Addendum Q 
to this Final Rule, available at <a href="https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient/regulations-notices/cms-1834-fc">https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient/regulations-notices/cms-1834-fc</a>.

Inpatient Hospital per Diem Rate (Excludes Physician/Practitioner 
Services)

Calendar Year 2026
    Lower 48 States: $5,707.
    Alaska: $5,208.

Outpatient per Visit Rate (Excluding Medicare)

Calendar Year 2026
    Lower 48 States: $826.
    Alaska: $1,222.

Outpatient per Visit Rate (Medicare)

Calendar Year 2026
    Lower 48 States: $733.
    Alaska: $1,233.

Medicare Part B Inpatient Ancillary per Diem Rate

Calendar Year 2026
    Lower 48 States: $1,289.
    Alaska: $1,617.

Outpatient Surgery Rate (Medicare)

    Established Medicare rates for freestanding Ambulatory Surgical 
Centers.
Effective Date for Calendar Year 2026 Rates
    Consistent with previous annual rate revisions, the Calendar Year 
2026 rates will be effective for services provided on or after January 
1, 2026, to the extent consistent with payment authorities, including 
the applicable Medicaid State plan.

Clayton W. Fulton,
Chief of Staff, Delegated Authority of the IHS Director.
[FR Doc. 2026-01178 Filed 1-21-26; 8:45 am]
BILLING CODE 4166-14-P


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Indexed from Federal Register on January 22, 2026.

This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.