Federal (United States) · Agency guidance
Chapter 15
222 sections
222 sections
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 10Supplementary Medical Insurance (SMI) Provisions
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 20When Part B Expenses Are Incurred
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 20.1Physician Expense for Surgery, Childbirth, and Treatment for Infertility
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 20.2Physician Expense for Allergy Treatment
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 20.3Artificial Limbs, Braces, and Other Custom Made Items Ordered But Not
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 30Physician Services
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 30.1Provider-Based Physician Services
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 30.2Teaching Physician Services
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 30.3Interns and Residents
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 30.4Optometrist’s Services
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 30.5Chiropractor’s Services
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 30.6Indian Health Service (IHS) Physician and Nonphysician Services
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 30.6.1Payment for Medicare Part B Services Furnished by Certain IHS Hospitals and
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40Effect of Beneficiary Agreements Not to Use Medicare Coverage
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.1Private Contracts Between Beneficiaries and Physicians/Practitioners
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.2General Rules of Private Contracts
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.3Effective Date of the Opt-Out Provision
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.4Definition of Physician/Practitioner
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.5When a Physician or Practitioner Opts Out of Medicare
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.6When Payment May be Made to a Beneficiary for Service of an Opt-Out
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.7Definition of a Private Contract
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.8Requirements of a Private Contract
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.9Requirements of the Opt-Out Affidavit
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.10Failure to Properly Opt Out
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.11Failure to Maintain Opt-Out
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.12Actions to Take in Cases of Failure to Maintain Opt-Out
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.13Physician/Practitioner Who Has Never Enrolled in Medicare
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.14Nonparticipating Physicians or Practitioners Who Opt Out of Medicare
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.15Excluded Physicians and Practitioners
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.16Relationship Between Opt-Out and Medicare Participation Agreements
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.17Participating Physicians and Practitioners
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.18Physicians or Practitioners Who Choose to Opt Out of Medicare
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.19Opt-Out Relationship to Noncovered Services
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.20Maintaining Information on Opt-Out Physicians
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.21Informing Medicare Managed Care Plans of the Identity of the Opt-Out
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.22Informing the National Supplier Clearinghouse (NSC) of the Identity of the
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.23Organizations That Furnish Physician or Practitioner Services
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.24The Difference Between Advance Beneficiary Notices (ABN) and Private
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.25Private Contracting Rules When Medicare is the Secondary Payer
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.26Registration and Identification of Physicians or Practitioners Who Opt Out
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.27System Identification
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.28Emergency and Urgent Care Situations
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.29Definition of Emergency and Urgent Care Situations
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.30Denial of Payment to Employers of Opt-Out Physicians and Practitioners
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.31Denial of Payment to Beneficiaries and Others
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.32Payment for Medically Necessary Services Ordered or Prescribed by an Opt-out
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.33Mandatory Claims Submission
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.34Cancellation of Opt-Out
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.35Early Termination of Opt-Out
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.36Appeals
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.37Application to the Medicare Advantage Program
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.38Claims Denial Notices to Opt-Out Physicians and Practitioners
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.39Claims Denial Notices to Beneficiaries
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50Drugs and Biologicals
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.1Definition of Drug or Biological
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.2Determining Self-Administration of Drug or Biological
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.3Incident To Requirements
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.4Reasonableness and Necessity
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.4.1Approved Use of Drug
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.4.2Unlabeled Use of Drug
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.4.3Examples of Not Reasonable and Necessary
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.4.4Payment for Antigens and Immunizations
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.4.4.1Antigens
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.4.4.2Immunizations
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.4.5Off-Label Use of Drugs and Biologicals in an Anti-Cancer Chemotherapeutic
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.4.5.1Process for Amending the List of Compendia for Determination of Medically-
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.4.6Less Than Effective Drug
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.4.7Denial of Medicare Payment for Compounded Drugs Produced in Violation of
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.4.8Process for Amending the List of Compendia for Determination of Medically-
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.5Self-Administered Drugs and Biologicals
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.5.1Immunosuppressive Drugs
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.5.2Erythropoietin (EPO)
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.5.2.1Requirements for Medicare Coverage for EPO
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.5.2.2Medicare Coverage of Epoetin Alfa (Procrit) for Preoperative Use
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.5.3Oral Anti-Cancer Drugs
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.5.4Oral Anti-Nausea (Anti-Emetic) Drugs
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.5.5Hemophilia Clotting Factors
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.6Coverage of Intravenous Immune Globulin for Treatment of Primary Immune
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 60Services and Supplies Furnished Incident To a Physician’s/NPP’s Professional
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 60.1Incident To Physician’s Professional Services
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 60.2Services of Nonphysician Personnel Furnished Incident To Physician’s Services
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 60.3Incident To Physician’s Services in Clinic
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 60.4Services Incident to a Physician’s Service to Homebound Patients Under General
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 60.4.1Definition of Homebound Patient Under the Medicare Home Health (HH)
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 70Sleep Disorder Clinics
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and Other Diagnostic
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.1Clinical Laboratory Services
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.1.1Certification Changes
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.1.2A/B MAC (B) Contacts With Independent Clinical Laboratories
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.1.3Independent Laboratory Service to a Patient in the Patient’s Home or an
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.2Psychological Tests and Neuropsychological Tests
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.3Audiology Services
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.3.1Definition of Qualified Audiologist
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.4Coverage of Portable X-Ray Services Not Under the Direct Supervision of a
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.4.1Diagnostic X-Ray Tests
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.4.2Applicability of Health and Safety Standards
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.4.3Scope of Portable X-Ray Benefit
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.4.4Exclusions From Coverage as Portable X-Ray Services
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.4.5Electrocardiograms
- Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 80.5Bone Mass Measurements (BMMs)