Outpatient medical & surgical services & supplies
Medicare Part B (Medical Insurance) covers approved outpatient services and supplies
Description
Outpatient services and supplies can include things like: X-rays, casts, stitches, or outpatient surgeries.
Costs
After you meet the Part B deductible , you pay 20% of the Medicare-approved amount for doctor or other health care provider services. You also generally pay 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, the copayment can’t be more than the Part A hospital stay deductible for each service you get.
You pay all costs for items or services that Medicare doesn’t cover.
Ask your doctor or healthcare provider how much your test, item, or service will cost.
Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.
Specific amounts you could owe depend on:
Other insurance you may have
How much your doctor charges
If your doctor accepts assignment
The type of facility
Where you get your test, item, or service