What Services Medicare Part B Will Cover

Part B medical insurance is intended to cover basic medical services provided by doctors, clinics, and laboratories. But the lists of services specifically covered and not covered are long. Making the effort to learn what is and isn't covered is important, because you can get the most benefits by fitting your medical treatments into the covered categories whenever possible. (For an explanation of how much of your covered costs Part B pays, see our article on what you pay for Medicare Part B services.)

What Medicare Part B Covers

Here are the services, medications, and supplies that Medicare Part B pays for.

Does Medicare Part B Cover Doctor Visits?

Part B medical insurance covers medically necessary doctors' services, whether the services are provided at the hospital, at a doctor's office, or—if you can find such a doctor—at home.

Part B also covers outpatient medical services provided by hospital staff or doctor's office staff who assist in providing care, such as nurses, nurse practitioners, surgical assistants, and laboratory or X-ray technicians.

Does Medicare Part B Cover Outpatient Surgery and Treatment?

Medicare Part B covers outpatient hospital treatment, such as surgery (when medically necessary), emergency room or urgent care charges, and injections that aren't self-administered. Medicare will also cover a second doctor's opinion before you undergo surgery. (Part A covers surgeries that you have while you're admitted as a patient to a hospital.)

Beware: Medicare pays only a limited amount of outpatient hospital and clinic bills. Unlike most other kinds of services, Medicare places no limits on how much the hospital or clinic can charge for outpatient services over and above what Medicare pays.

Does Part B Cover Laboratory Testing and Diagnostic Tests?

Medicare Part B covers laboratory work, X-rays, CT scans, MRIs, EKGs, and other diagnostic tests when you're not a patient in a hospital or skilled nursing facility. Lab work and tests can be done at a hospital lab or at an independent laboratory facility, as long as that lab is approved by Medicare.

Part B covers a yearly mammogram, even if you haven't met your annual deductible. The mammogram must be performed by your doctor or by a facility certified for mammography by Medicare.

Is There a Limit on Outpatient Physical Therapy and Speech Therapy?

Medicare Part B covers much of the cost of outpatient physical, occupational, and speech therapy—if it's prescribed and regularly reviewed by a doctor and provided by a Medicare-approved facility or therapist.

For therapy received at an office or rehab facility, rather than a hospital's outpatient department, Medicare will pay 80% of the Medicare-approved amount (with traditional Medicare, rather than Medicare Advantage). You are responsible for the other 20%, unless you have a supplemental medigap insurance plan that will cover it. (If you have a Medicare Advantage plan, you may have to pay a small copay instead.) The copay for therapy provided at a hospital's outpatient department or as a part of home health care may be lower.

There's no limit or "therapy cap" to the amount of physical therapy (PT), occupational therapy (OT), or speech-language pathology (SLP) services that you can receive. But, after a certain amount of spending on these services, your doctor must submit more documentation to Medicare to show that continued therapy is medically necessary. In 2024, that threshold amount is $2,330 for OT and $2,330 for PT/SLP combined. This amount increases slightly each year.

Does Part B Cover Ambulance Rides?

Part B medical insurance will cover the cost of transporting a patient by ambulance if it's medically necessary (that is, if transport by any other means wouldn't be medically advisable). This means Part B may cover not only emergencies, but also nonemergency trips following discharge from a hospital—for example, to the patient's home or to a nursing facility.

Transporting residents of nursing facilities to see their doctors may also be covered. But Medicare doesn't cover ambulance transport for regular visits from a person's home to a doctor's office, if the trip was arranged simply because the person needed some assistance.

If your doctor prescribes an ambulance for you for a trip from home to the doctor's office, Medicare may cover it but it isn't required to. Medicare will cover the ambulance trip only if the doctor's communication with Medicare convinces Medicare that the ambulance was medically necessary. For example, someone with end-stage kidney disease may need ambulance transport to and from a kidney dialysis facility.

If Medicare covers an ambulance trip, the ambulance company must accept the Medicare-approved amount as full payment for its services. Medicare will pay 80% of that amount. You, or your medigap insurer or your Medicare Advantage plan, are responsible for paying the remaining 20%. The ambulance company can't bill you for any amount over that 20%.

Does Part B Cover Self-Administered Drugs?

Part B covers drugs or other medicines administered to you at doctor's office. But Medicare Part B doesn't cover many drugs you take by yourself at home, including self-administered injections, even if your doctor prescribes them.

There are some exceptions to this rule. Here are some examples of self-administered drugs covered by Part B:

• self-administered oral cancer medication (if it's also given as an injectable)
• immunosuppressive drugs for transplants
• injectable osteoporosis drugs
• antigens
• insulin.

If you use an insulin pump covered under Medicare Part B's durable medical equipment benefit or you get insulin through your Medicare Advantage Plan, the following rules apply:

• Your monthly cost for Part B-covered insulin is capped at $35.
• This $35 cap for a month's supply applies regardless of whether you receive a one-month or three-month supply.
• The Part B deductible doesn't apply to this insulin coverage.

Also, flu, COVID-19, pneumonia, and hepatitis B vaccines are covered by Medicare Part B, even though other vaccinations are not. The flu and COVID-19 shots you can obtain on your own, but the pneumonia vaccination requires a doctor's prescription.

Most other vaccinations and drugs you take at home can be covered by a Medicare Part D plan.

Does Medicare Cover Medical Equipment and Supplies?

Medicare Part B covers many types of medical equipment and supplies, as long as they're prescribed by a doctor. The following types of equipment and supplies are covered by Part B:

• splints
• casts
• prosthetic devices
• body braces
• heart pacemakers
• corrective lenses after a cataract operation
• therapeutic shoes for diabetics
• glucose monitoring equipment for diabetics
• ventilators
• wheelchairs, and
• hospital beds.

To learn more about the many types of medical equipment and supplies Medicare Part B covers, and how different equipment may be rented or purchased, see Medicare's publication Medicare Coverage of Durable Medical Equipment and Other Devices.

To find a Medicare-certified supplier of medical equipment near you, go to the Medicare website home page at www.medicare.gov and click on "Providers & services" and then "Find medical equipment and suppliers."

Does Part B Cover Oral Surgery?

Part B medical insurance will cover some types of surgery on the jaw or facial bones, or on the related nerves or blood vessels. However, surgery on teeth or gums, even when related to an injury or a disease that didn't originate with the teeth, might be considered dental work and not be covered by Medicare.

But if the treatment involves the bones, inside mouth, blood vessels, or tongue, rather than just the teeth and gums, Part B may cover it. If the work is done by an oral surgeon who isn't an M.D., Medicare will cover the work if it's the kind of treatment M.D.s also provide, and if Medicare would cover the care if an M.D. had provided it.

Does Medicare Cover Chiropractors?

Part B may cover some care by Medicare-certified chiropractors. Generally, Medicare will cover a limited number of visits to a chiropractor for manipulation of neck or back vertebrae that are out of place. Medicare won't, however, cover general health maintenance visits to a chiropractor, nor will it usually cover therapeutic manipulation other than of the vertebrae. And Medicare generally won't cover X-rays or other diagnostic tests ordered or performed by the chiropractor. Instead, your physician normally must order these tests.

If you go to a chiropractor and hope to have Medicare pay its share of the bill, have the chiropractor's office check with Medicare ahead of time about the treatment being proposed. Even if Medicare initially agrees to covers the treatment, it might not do so indefinitely. So, if you continue with the treatments, have the chiropractor's office regularly check with Medicare to find out how long it will keep paying.

Does Part B Cover Preventive Screening Exams?

Medicare Part B covers the following examinations to screen for a number of serious illnesses:

• a one-time routine physical exam (sometimes called an "initial wellness exam") within six months of the date a person first enrolls in Part B coverage
• an annual physical exam that includes a comprehensive risk assessment, which might lead to further Medicare-covered testing
• a Pap smear and pelvic exam for women every three years; every year for those at high risk of cervical or pelvic disease (not subject to the Part B deductible)
• colorectal cancer screening, as your physician deems necessary
• bone density tests for women at high risk of developing osteoporosis or in certain other cases
• blood glucose testing supplies—if prescribed by a physician—for patients with diabetes
• annual prostate cancer screenings for men over 55
• positron emission tomography (PET) scans, a diagnostic test for certain cancers
• annual eye screening for glaucoma
• blood screening for early detection of cardiovascular disease, if your doctor says you have risk factors
• screening test for diabetes, if your doctor says you're at risk for the disease, and
• PET brain scans for patients with Alzheimer's-like symptoms, if your doctor believes the source may be a different type of brain disease known as "frontotemporal dementia."

Does Part B Cover Podiatrists and Optometrists?

Medicare covers podiatrist services only when they consist of treatment for injuries or diseases of the foot. Medicare doesn't cover routine foot care or treatment of corns or calluses.

Medicare doesn't cover optometrist appointments for routine eye examinations, glasses, or contact lenses. The only exception is for people who have undergone cataract or other eye surgery. For them, Medicare covers glasses, contact lenses, or intraocular lenses, as well as the cost of an examination by a Medicare-certified optometrist.

Does Medicare Cover Mental Health Care?

Medicare Part B will cover mental diagnostic tests and psychiatric evaluations, including one depression screening per year and a yearly mental health wellness visit. Part B can also cover counseling and psychotherapy by Medicare-enrolled clinical psychologists or psychiatrists (and in some states, by other licensed professionals). Treatment for substance use disorders, including opioid treatment programs for opioid use disorder, is also covered by Part B.

For severe mental health issues, Part B will cover mental health care in the form of day treatment—also called partial hospitalization—at a hospital outpatient department or community mental health center. The facility must be Medicare-approved and the particular day program must be certified by Medicare. Also, your doctor must certify that you would otherwise need inpatient mental health treatment. (Part A covers inpatient mental health treatment.)

Part B will also pay for intensive outpatient program services at a hospital, community mental health center, Federally Qualified Health Center, or Rural Health Clinic.

Does Part A or Part B Cover Home Health Care?

The same home health care coverage is available under Part B medical insurance as is provided by Part A hospital insurance. (See our article on Medicare coverage of home health care.) Part B generally covers home health care when it doesn't follow a three-day hospital or skilled nursing facility stay.

There's no limit on the number of home health care visits that are covered, and you aren't responsible for your Part B deductible to use home health care. But Medicare only covers skilled nursing care or therapy while you're confined to your home ("homebound"), and the home care must be ordered by your doctor and provided by a Medicare-approved home health care agency.

Part B medical insurance, like Part A coverage, will pay 100% of the approved charges of a participating home health care agency.

Services That Medicare Part B Won't Cover

To learn what services Medicare Part B won't cover, see our article on services not covered by Medicare Part B.