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.
Reference: https://www.cms.gov/transmittals/Downloads/R11GI.pdf
Also see the complete list of services and procedures for which annual deductibles and coinsurance may apply
