Tribal Health Providers

Medicaid & Long-Term Care

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What you need to know

​​​​​​​​There are numerous federal laws and treaties which impact the administration of care for Tribes, this section of the Medicaid website provides information for Tribal Health Providers enrolled in Nebraska Medicaid.

See more information for Medicaid providers.

Encounter Rate

Each year Indian Health Services (IHS) approves the All-Inclusive Rate (AIR), also known as the encounter rate. This is the reimbursement rate for inpatient and outpatient medical care provided by IHS and 638 Tribal Health Facilities for Medicaid beneficiaries. These rates are published periodically in the Federal Register.

During the COVID-19 Public Health Emergency, telehealth services can be billed at the encounter rate as long as they meet all necessary requirements. Services provided must also follow the four walls rule for this to be applicable, with either the patient or practitioner located within the facility when services are rendered. 

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638 Tribal Facilities

ITU is an abbreviated acronym that refers to different types of providers who serve people in Tribal communities. Each letter in ITU stands for a different type of provider. 

  • 'I' stands for Indian Health Services, which is the primary provider of healthcare to the Tribes through DHHS.
  • 'T' stands for Tribal Health Facilities, which are health facilities owned and operated by the Tribes. 
  • 'U' stands for the Urban Indian Health Program, which provides healthcare to Tribal members through facilities in urban settings outside of tribal land.
Tribal Health Facilities can receive the funds that IHS would have used to provide direct health services for Tribal members through a contract, and this is known as “638 contracting." These are then referred to as 638 Tribal Health Facilities, and such facilities can use the contracted funds from IHS to provide a broad range of health services to Tribal members​.

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