Exceptions to Annual Deductible and Coinsurance

20.4 - Exceptions to Annual Deductible and Coinsurance (Rev. 11, Issued: 10-22-04, Effective: 11-22-04, Implementation: 11-22-04) There is no deductible for screening mammography effective for services January 1, 1998 and later. Neither the annual deductible nor the 20 percent coinsurance apply with respect 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; • 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. NOTE: Services which are not subject to the deductible cannot be used to satisfy the deductible.