HI 00610.360 Outpatient Hospital Services

All covered outpatient hospital services, as well as physicians' services furnished to outpatients by a participating hospital, are reimbursable under Part B subject to the annual cash deductible and 20 percent coinsurance, and if applicable, the blood deductible.

Certain diagnostic tests needed in connection with a hospital admission that are done on an outpatient basis may be paid for at 100% of the reasonable costs. (See HI 00610.010 D.3.)

A. Diagnostic services

Diagnostic services include all services and supplies in connection with a diagnostic procedure (including any drugs and biologicals required in the performance of such procedures) furnished by or under arrangements made by the hospital, if furnished in the hospital or elsewhere under the supervision of the hospital or its organized medical staff. Diagnostic services furnished outside the hospital premises by hospital personnel are covered without the direct personal supervision of a physician.

B. Hospital services incident to physicians' services to outpatients

Hospital services incident to physicians' services to outpatients include services and supplies (including the use of hospital facilities) furnished on a physician's order by hospital personnel under hospital medical staff supervision in the hospital or, if outside the hospital, under the personal supervision of a physician who is treating the patient. Drugs and biologicals furnished to outpatients for other than diagnostic purposes are includable only if they are of a type which cannot be self-administered.


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HI 00610.360 - Outpatient Hospital Services - 07/16/2014
Batch run: 07/16/2014
Rev:07/16/2014