Understanding Medicare Part B – What Does It Cover and How is It Related to Medical Billing?

For Medicare beneficiaries in the US, understanding Medicare Part B is key to having access to important health services and treatments. Buying a Part B plan is the first step towards receiving medical coverage, so it is important to know what it covers and how it is related to medical billing.

What Does Medicare Part B Cover?

Medicare Part B is a supplemental plan designed to cover medically necessary services and supplies. It includes medically necessary lab tests, doctor visits, preventive services, ambulance services, durable medical equipment, and other services and supplies as needed.

Part B also helps to cover some preventive care services, such as flu shots and wellness visits. It also covers certain services and supplies related to mental health and substance abuse treatment, as well as home health services and outpatient physical and occupational therapy.

How is It Related to Medical Billing for Medicare Beneficiaries?

When a service or supply is covered by Medicare Part B, the beneficiary’s doctor or other healthcare provider will bill Medicare for the cost whenever possible. Medicare Part B pays 80 percent of the approved amount after the beneficiary pays the deductible. The beneficiary will then need to pay for the remaining balance, known as the coinsurance.

It is important for Medicare beneficiaries to review their medical bills carefully to ensure that they are not being charged for services or supplies that should have been covered by Part B. In some cases, Medicare Part B might not cover the entire cost of a service or supply, and the beneficiary may need to cover the remaining balance.

Conclusion

For Medicare beneficiaries, Medicare Part B is an important source of coverage for medically necessary services and supplies. It is important to understand what is covered by Part B, and how it relates to medical billing. Knowing what is covered can help to ensure that beneficiaries are not being charged for services and supplies that should have been covered by their Part B plan.