Outpatient medical & surgical services & supplies

Medicare Part B (Medical Insurance) covers approved outpatient services and supplies, 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 also usually 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. 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?