Outpatient hospital services


Medicare Part B (Medical Insurance) covers medically necessary diagnostic and treatment services you get as an outpatient from a Medicare-participating hospital. Covered Outpatient hospital services may include:

• Emergency or observation services, which may include an overnight stay in the hospital
• Services in an outpatient clinic, including same-day surgery
• Laboratory tests billed by the hospital
• Mental health care in a partial hospitalization program, if a doctor certifies that inpatient treatment would be required without it
• X-rays and other radiology services billed by the hospital
• Medical supplies, like splints and casts
• Preventive and screening services
• Certain drugs and biologicals that you wouldn’t usually give yourself

Who’s eligible?

All people with Medicare are covered.

Your costs in Original Medicare

• You generally pay 20% of the Medicare-approved amount for the doctor or other health care provider’s services, and the Part B deductible applies.
• For all other services, you also generally pay a copayment for each service you get in an outpatient hospital setting. You may pay more for services you get in a hospital outpatient setting than you would pay for the same care in a doctor’s office.
• For some screenings and preventive services, coinsurance, copayments, and the Part B deductible don’t apply (so you pay nothing).