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Outpatient Hospital Services Medicare Coverage Detailed

Your Medicare Coverage

Outpatient Hospital Services Detailed

Coverage: Conditions that must be met before Medicare will provide coverage, and limits to coverage.

Medicare Part B covers medically necessary services you get as an outpatient from a Medicare-participating hospital for diagnosis or treatment of an illness or injury.

Covered outpatient hospital services include:

  • Services in an emergency room or outpatient clinic, including same-day surgery;
  • Laboratory tests billed by the hospital;
  • Mental health care in a partial hospitalization program, if a physician certifies that inpatient treatment would be required without it;
  • X-rays and other radiology services billed by the hospital;
  • Medical supplies such as splints and casts; and
  • Drugs and biologicals that you cannot give yourself.

CoPayment: The amount you need to pay.

You pay 20% of Medicare-approved amounts for the doctor.

You pay a set copayment amount based on each service received.

Medicare Part: The part of Medicare that pays for this service or supply.

B

Organization Name: The organization name that this coverage topic is associated with.

Important Notes: Details regarding important notes about the coverage.

You must pay an annual $147 deductible for Part B services and supplies before Medicare begins to pay its share.