MedicaidCoverageLow impact
Indian Health Services Provider Bulletin 2: Billing for Pharmacy Services Rendered by Indian Health Services Facilities
MassHealth·MA·Pharmacy
Effective date
May 15, 2025
We identified it
Jun 18, 2026
Summary
Beginning May 15, 2025, Indian Health Services facilities and tribal facilities participating in MassHealth may bill for pharmacy services using the all-inclusive rate applicable to IHS facilities per federal law. This expands covered services to include pharmacy services rendered by these specific facility types.
Action Required
By May 15, 2025: If your practice is an Indian Health Services facility or Public Law 93-638 tribal facility participating in MassHealth, billing team must update system to bill pharmacy services using the all-inclusive IHS encounter rate per Federal Register guidance. Verify facility eligibility and update billing procedures for pharmacy services to use appropriate IHS billing methodology.