Original Medicare (Parts A & B): Laboratory Tests, Outpatient Medical and Surgical Services and Supplies

Includes medically necessary diagnostic lab tests and other approved outpatient procedures when ordered by a provider.

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Cost
Generally $0 for lab tests and surgical dressing supplies; 20% of the Medicare-approved amount for provider services; copay for each hospital outpatient service; Part B deductible applies
Prior Authorization Required
No
Provider Referral or Order Required
Yes

How To Receive

Details on how to apply

  1. Obtain a provider order for the specific diagnostic testing or outpatient procedure.

  2. Schedule the test(s) or procedure(s) at a facility enrolled in Medicare.

  3. Attend the appointment and complete the testing or procedure.

  4. Follow through on any recommendations or referrals made based on results.

Note that there is generally a copay for each service provided in a hospital outpatient setting, though in most cases the copay cannot be more than the Part A hospital stay deductible for each service received, and your loved one is responsible for all costs for items or services that Medicare does not cover.

For more information on Medicare benefits and coverage, call 1-800-MEDICARE (1-800-633-4227) or visit the Medicare Benefits Website. TTY users, call 1-877-486-2048.

Availability
As ordered by a provider

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Covered services

Note that covered services are not limited to these items.

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