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Medicare Benefit Policy Manual


                         Chapter 15 – Covered Medical and Other Health

                                                        Services


                                                     Table of Contents
                                                   (Rev. 11901, 03-16-23)

                   Transmittals for Chapter 15

                   10 - Supplementary Medical Insurance (SMI) Provisions

                   20 - When Part B Expenses Are Incurred
                        20.1 - Physician Expense for Surgery, Childbirth, and Treatment for Infertility
                        20.2 - Physician Expense for Allergy Treatment
                        20.3 - Artificial Limbs, Braces, and Other Custom Made Items Ordered But Not
                        Furnished
                   30 - Physician Services
                        30.1 - Provider-Based Physician Services
                        30.2 - Teaching Physician Services
                        30.3 - Interns and Residents
                        30.4 - Optometrist’s Services
                        30.5 - Chiropractor’s Services

                        30.6 - Indian Health Service (IHS) Physician and Nonphysician Services
                                 30.6.1 - Payment for Medicare Part B Services Furnished by Certain IHS
                                 Hospitals and Clinics
                   40 - Effect of Beneficiary Agreements Not to Use Medicare Coverage
                        40.1 - Private Contracts Between Beneficiaries and Physicians/Practitioners

                        40.2 - General Rules of Private Contracts
                        40.3 - Effective Date of the Opt-Out Provision
                        40.4 - Definition of Physician/Practitioner
                        40.5 - When a Physician or Practitioner Opts Out of Medicare
                        40.6 - When Payment May be Made to a Beneficiary for Service of an Opt-Out
                        Physician/Practitioner
                        40.7 - Definition of a Private Contract
                        40.8 - Requirements of a Private Contract
                        40.9 - Requirements of the Opt-Out Affidavit
                        40.10 - Failure to Properly Opt Out
                        40.11 - Failure to Maintain Opt-Out
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