Applicability of the Limitation on Liability Provision to Claims

130.1 - Applicability of the Limitation on Liability Provision to Claims for Ancillary, Outpatient Provider and Rural Health Clinic Services Payable Under Part B (Rev. 3187, Issued: 02-06-15, Effective: 03-06-15, Implementation: 03-06-15) The following sections discuss how the limitation on liability provision is applied to claims involving ancillary, outpatient and rural health clinic services billed to the A/B MAC (A), where reimbursement is sought under Part B. The A/B MAC (A) determines whether limitation on liability applies to these categories of claims when the basis for the denial is that the services were not reasonable and necessary (under §1862(a)(l) of the Act).