Outpatient medical & surgical services & supplies

Medicare Part B (Medical Insurance)

 covers approved procedures, like X-rays, casts, stitches, or outpatient surgeries.

Your costs in Original Medicare

You pay 20% of the 

Medicare-Approved Amount

 for your doctor’s or other health care provider’s services. You usually pay the hospital a 

copayment

 for each service you get in a hospital outpatient setting. There are exceptions for costly surgical procedures (called “comprehensive services”), like total knee replacements. For these services, you pay 20% for the entire episode of care, including any drugs, laboratory tests, and other services.

In most cases, for each service provided, the copayment can’t be more than the Part A hospital stay 

deductible [glossary]

. The Part B deductible applies, and you pay all costs for items or services that Medicare doesn’t cover.

Is my test, item, or service covered?

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