Payment may be made for the following medical and other health services when furnished
by a nonparticipating provider or by a supplier to patients of nonparticipating institutions
(including institutions which do not meet the definition of an “emergency” hospital). Similarly, such paymetn may be made for such services furnished on or
after April 1, 1968, to patients of participating institutions when they are not eligible
for Part A benefits (see C. above).
diagnostic X-ray tests, diagnostic laboratory tests, and other diagnostic tests (an
institution furnishing these services must meet the hospital conditions of participation
applicable to such services);
X-ray, radium, and radioative isotope therapy, including materials and services of
technicians (an institution furnishing these services must meet the hospital conditions
of participation applicable to such services);
services of residents and interns, nurses, therapists, etc., which are directly related
to the provision of diagnostic X-ray or laboratory or other diagnostic tests, or the
provisions of x-ray or radium therapy.
surgical dressings, and splints, casts, and other devices used for reduction of fractures
prosthetic devices other than dental which replace all or part of an internal body
organ, including replacement of such devices; and
leg, arm, back and neck braces, and artificial arms, legs, and eyes, including replacements
In addition the rental or purchase of durable medical equipment for use in the patient's
home or in an institution which can be considered his home may be covered. (See HI 00610.190 for instructions relating to durable medical equipment and the definition of a beneficiary's
Payments cannot be made to a nonparticipating SNF for the services listed in 1.-3.
above except for diagnostic laboratory services unless the SNF bills for these services
as an approved independent laboratory, and for portable X-ray services furnished in
a setting which meets the definition of the beneficiary's home if the SNF bills for
these services as a supplier of such services.
Payment may also be made for outpatient physical therapy and speech pathology services
furnished by a participating provider of services. (See HI 00610.370)