Medicare Part B covers a wide range of products and services primarily focused on medically necessary items, durable medical equipment (DME), certain outpatient prescription drugs, and preventive services. The types of products billed to Medicare Part B include:
- Durable Medical Equipment (DME): Such as wheelchairs, walkers, hospital beds, power scooters, portable oxygen equipment, and related supplies.
- Prosthetic devices: Artificial limbs, eyes, and braces.
- Medical supplies: Surgical dressings, splints, casts, diabetic shoes, ostomy supplies, and supplies used with DME like lancets and test strips for diabetes monitoring.
- Outpatient drugs and biologicals: Drugs that are not usually self-administered by the patient, such as infusion drugs, injectable osteoporosis drugs, blood clotting factors, immunosuppressants, oral anticancer and antiemetic drugs, inhalation drugs used with nebulizers, and certain home infusion drugs.
- Preventive vaccines: Including influenza, pneumococcal, hepatitis B, and COVID-19 vaccines.
- Other covered services and items: Laboratory tests, ambulance services, some outpatient hospital and surgical services, some physical therapy and rehabilitation services, and opioid treatment programs.
Medicare Part B mainly covers drugs and biologicals administered by a healthcare provider or used with durable medical equipment, often reimbursed based on Average Sales Price methodologies. Medications for specific diseases and conditions, including those for end-stage renal disease (ESRD) and hemophilia, are also covered. This coverage list reflects both medical necessity and prevention, focusing on items and drugs that support diagnosis, treatment, and durable equipment use in outpatient or non-hospital settings.
