Medicare Part B Physician Coverage

Medicare Part B - Physician

Medical Expenses:

Medicare Covers

You Pay

physician’s services,
inpatient and
outpatient medical
services, physical and
speech therapy,
diagnostic tests

80%
of approved
amount

$135
annual deductible
plus
20%
of approved
amount

Clinical Laboratory
Services:
blood tests
urinalysis

Generally
100%
of approved
amount

Nothing

Home Health Care:
part-time or intermittent
skilled care, home
health aide services,
durable medical
supplies and other
services

100% of
approved amount
80% of approved
amount for durable
medical equipment

Nothing for services
$135 Deductible
plus 20%
of approved amount
for durable medical
equipment

Outpatient Hospital
Treatment:
services for the
diagnosis of an
illness or injury

Medicare pays a set amount
based on prospective
payment system
(after $135 deductible)

$135 Deductible plus a
co-insurance or fixed
co-payment amount for
each service based on
prospective payment system

Blood

After first 3
pints of blood,
80% of
approved
amount

First 3 pints then
$135 Deductible
plus 20%
of approved
amount for
additional pints

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