Page 246 - Medicare Benefit Policy Manual

fibrotic tissue has developed. This condition may require a longer treatment time, but not
with higher frequency.

Some chiropractors have been identified as using an “intensive care” concept of
treatment. Under this approach multiple daily visits (as many as four or five in a single
day) are given in the office or clinic and so-called room or ward fees are charged since
the patient is confined to bed usually for the day. The room or ward fees are not covered
and reimbursement under Medicare will be limited to not more than one treatment per
day.

250 - Medical and Other Health Services Furnished to Inpatients of
Hospitals and Skilled Nursing Facilities
(Rev. 182, Issued: 03-21-14, Effective: 10-01-13, Implementation: 04-21-14)

There are several services which, when provided to a hospital or SNF inpatient, are
covered under Part B, even though the patient has Part A coverage for the hospital or
SNF stay. Those services are:

Physicians’ services (including the services of residents and interns in unapproved
teaching programs);

Physician assistant services, furnished after December 31, 1990;

Certified nurse-midwife services, as described in §180, furnished after December
31, 1990; and

Qualified clinical psychologist services, as defined in §160, furnished after
December 31, 1990;

Screening mammography services;

Screening pap smears and pelvic exams;

Screening glaucoma services;

Influenza, pneumococcal pneumonia, and hepatitis B vaccines and their
administrations;

Colorectal screening;

Bone mass measurements; and

Prostate screening;

Pneumococcal and hepatitis B vaccine services must be provided directly or arranged for
by the hospital in order to be covered when furnished to a hospital inpatient. The other