Medicare_Carriers_Manual / 2255 / 2255

Why This Topic Matters

The section helps readers determine whether inpatient services in hospitals or skilled nursing facilities fall within Part B payment rules when Part A coverage is unavailable or limited. It also identifies service categories that are treated differently for inpatient billing and payment policy review.

Article Sections

1. Ed. Note: For further information see

   A brief editorial note pointing readers to related manual material for additional policy context.

2. 2255. Medical and Other Health Services Furnished to Inpatients of Hospitals and Skilled Nursing Facilities

   An overview of Medicare Part A and Part B payment relationships for inpatient hospital and skilled nursing facility services, including general circumstances in which Part B coverage may be available.

3. A. Conditions for Part A Payment

   General policy conditions discussed for situations in which Part B payment may apply when Part A payment is not available, including inpatient stay circumstances and coverage status considerations.

4. B. Bundling of Services to Hospital Inpatients

   Policy guidance describing how certain hospital inpatient services are handled for billing purposes and the role of hospital arrangements in submitting claims.

5. C. Covered Part B Services When Part A Coverage is Not Available

   A list of broad service categories that may be covered under Part B when Part A coverage is not available for hospital or skilled nursing facility inpatients.

6. D. Services Always Covered Under Part B

   A discussion of inpatient services that remain covered under Part B even when Part A coverage exists, along with related policy context.