Are deductible and coinsurance applicable to CAH services?
• Inpatient claims are subject to the Part A deductible and coinsurance days. • Outpatient claims are subject to the Part B deductible and coinsurance, with the exception of pneumococcal pnuemonia vaccines (PPV), influenza vaccines, screening mammograms, and clinical diagnostic laboratory tests. PPV, influenza, and clinical diagnostic laboratory tests are not subject to the Part B deductible and coinsurance. • Screening mammograms are not subject to the Part B deductible, but coinsurance does apply. Reference: CMS Pub.
• Inpatient claims are subject to the Part A deductible and coinsurance days. • Outpatient claims are subject to the Part B deductible and coinsurance, with the exception of pneumococcal pneumonia vaccines (PPV), influenza vaccines, screening mammograms, and clinical diagnostic laboratory tests. PPV, influenza, and clinical diagnostic laboratory tests are not subject to the Part B deductible and coinsurance. • Screening mammograms are not subject to the Part B deductible, but coinsurance does apply. Reference: CMS Pub.
