The Indian Health Service would like to share the updated Indian Health Service (IHS) Medical Priority Levels and to initiate consultation thereon before implementation. The IHS establishes medical priorities in accordance with 42 CFR 136.23(e) to ensure that the authorization of Purchased/Referred Care (PRC) services are based on relative medical need. The Medicare National Coverage Determinations Manual from the Centers for Medicare & Medicaid Services and current medical literature are used as a basis for medical priority-level decision-making. The IHS Medical Priority Levels are updated periodically as the medical community develops new methods for treating healthcare needs. Written comments are due on October 27, 2023.