Page 1 - Medicare Benefit Policy Manual

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