CMS Transmittals

Does coinsurance and Deductible applies for Home health services?

According to CMS Transmittals CR 3471 (20.4 – Exceptions to Annual Deductible and Coinsurance) neither the annual deductible nor the 20 percent coinsurance apply to Parts A and B home health services, except that there is a coinsurance of 20 percent of the payment amount for supplies, drugs, DME and prosthetics /orthotics furnished as a home health benefit.

The annual Deductible and Coinsurance is not appicable for the below services / procedures too

• Clinical diagnostic laboratory tests (including specimen collection fees) performed or supervised by a physician,

laboratory, or other entity paid on an assigned basis;

• Pneumococcal vaccine and its administration;

• Influenza vaccine and its administration; and

• Services or items denied as medically unnecessary.


Also see the complete list of services and procedures for which annual deductibles and coinsurance may apply

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