Page 1 - Medicare Benefit Policy Manual
P. 1
Medicare Benefit Policy Manual
Chapter 16 - General Exclusions From Coverage
Table of Contents
(Rev. 198, 11-06-14)
Transmittals for Chapter 16
10 - General Exclusions from Coverage
20 - Services Not Reasonable and Necessary
30 - Foot Care
40 - No Legal Obligation to Pay for or Provide Services
40.1 - Indigence
40.2 – Provider, Physician, or Supplier Bills Only Insured Patients
40.3 - Medicare Patient Has Other Health Coverage
40.4 - Items Covered Under Warranty
40.5 - Members of Religious Orders
40.6 - Ambulance Services
50 - Items and Services Furnished, Paid for or Authorized by Governmental Entities -
Federal, State, or Local Governments
50.1 - Items and Services Which a Non-Federal Provider Furnishes Pursuant to an
Authorization Issued by a Federal Agency
50.1.1 - Veterans’ Administration (VA) Authorized Services
50.1.2 - Medicare Secondary Payment Where VA Authorizes Fewer Days
Than Total Number of Covered Days in the Stay
50.1.3 - Effect of VA Payments on Medicare Deductible and Utilization
50.1.4 - VA “Fee Basis Card"
50.1.5 - Services Authorized by Indian Health Service
50.2 - Items and Services Furnished by Federal Provider of Services or Federal
Agency
50.3 - Items or Services Paid for by Governmental Entity
50.3.1 - Application of Exclusion to State and Local Government Providers
50.3.2 - Application of Exclusion to Nongovernmental Providers,
Physicians and Suppliers
50.3.3 - Examples of Application of Government Entity Exclusion
