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What types of services are covered under Medicare Part B?

What Types of Services Are Covered Under Medicare Part B?

Medicare Part B is a core component of “Original Medicare,” acting as your medical insurance for services and supplies that are typically provided outside of a hospital stay. While Medicare Part A covers inpatient hospital care, Part B is designed to handle the “day-to-day” medical needs that keep you healthy and manage chronic conditions.

 

As of 2026, the standard monthly premium for Medicare Part B is $202.90, and the annual deductible is $283. Once you meet this deductible, Medicare generally pays 80% of the Medicare-approved amount for covered services, leaving you responsible for the remaining 20% coinsurance.

 

Below is a detailed breakdown of the primary services covered under Medicare Part B.

1. Medically Necessary Doctor’s Services

The cornerstone of Part B is coverage for services from doctors and other health care providers. This includes:

 

  • Office Visits: Routine appointments with primary care physicians or specialists to diagnose or treat a medical condition.

     

  • Outpatient Surgery: Procedures performed in an ambulatory surgical center or a hospital outpatient department.

     

  • Consultations: Second opinions for non-emergency surgeries and visits to specialists like cardiologists, endocrinologists, or orthopedists.

     

2. Preventive Services and Screenings

One of the most valuable aspects of Part B is its focus on prevention. Many of these services are available at no cost to you (zero coinsurance or deductible) if your doctor accepts “assignment.”

 

  • “Welcome to Medicare” Visit: A one-time introductory visit within your first 12 months of enrollment.

     

  • Annual Wellness Visits: Yearly appointments to develop or update a personalized prevention plan.

     

  • Vaccinations: Coverage for flu shots, pneumococcal shots, COVID-19 vaccines, and Hepatitis B shots (for those at medium to high risk).

     

  • Cancer Screenings: Regular screenings for breast (mammograms), cervical, colorectal, lung, and prostate cancers.

     

  • Heart Disease & Diabetes: Screenings for cholesterol, blood pressure, and diabetes, as well as medical nutrition therapy for those with diabetes or renal disease.

     

3. Durable Medical Equipment (DME)

Medicare Part B covers equipment that is reusable, medically necessary, and intended for use in the home. Common examples include:

 

  • Mobility Aids: Walkers, canes, crutches, manual wheelchairs, and power scooters.

     

  • Home Supplies: Hospital beds, oxygen equipment, and nebulizers.

     

  • Diabetes Supplies: Blood sugar monitors, test strips, lancets, and certain continuous glucose monitors (CGMs).

     

  • CPAP Devices: For those diagnosed with obstructive sleep apnea.

     

4. Mental Health Services

Part B covers outpatient mental health care provided by psychiatrists, clinical psychologists, clinical social workers, and—as of recent expansions—licensed marriage and family therapists and mental health counselors. Covered services include:

 

  • Psychotherapy: Individual and group therapy sessions.

     

  • Depression Screenings: One free annual screening in a primary care setting.

     

  • Psychiatric Evaluations: Diagnostic tests to assess mental health status.

     

  • Intensive Outpatient Programs (IOP): Structured programs for those needing more frequent support than standard therapy but not requiring 24-hour hospitalization.

     

5. Ambulance and Emergency Services

Part B covers ground ambulance transportation when you need to be transported to a hospital, critical access hospital, or skilled nursing facility for medically necessary services, and transportation in any other vehicle could endanger your health. In limited cases, such as life-threatening emergencies where ground transport is too slow, emergency air ambulance (helicopter or airplane) may also be covered.

 

6. Clinical Research and Outpatient Lab Tests

  • Lab Tests: Includes blood tests, urinalysis, and certain tissue screenings.

     

  • Imaging: X-rays, MRIs, CT scans, and EKGs.

     

  • Clinical Research: Costs for certain items and services provided in federally funded clinical research studies.

     

What is NOT Covered?

It is important to remember that Medicare Part B generally does not cover:

  • Routine dental care (cleanings, fillings, or dentures).

     

  • Routine vision exams or eyeglasses (except following cataract surgery).

     

  • Hearing aids and exams for fitting them.

     

  • Long-term care (custodial care in a nursing home).

  • Most prescription drugs (these are covered under Part D).

Helpful Resources

For more information or to check specific coverage, visit these official resources: