covered OPD services

(B)For purposes of this subsection, the term “covered OPD services”— (i)means hospital outpatient services designated by the Secretary; (ii)subject to clause (iv), includes inpatient hospital services designated by the Secretary that are covered under this part and furnished to a hospital inpatient who (I) is entitled to benefits under part A but has exhausted benefits for inpatient hospital services during a spell of illness, or (II) is not so entitled; (iii)includes implantable items described in paragraph (3), (6), or (8) ofsection 1395x(s) of this title; (iv)does not include any therapy services described in subsection (a)(8) or ambulance services, for which payment is made under a fee schedule described insection 1395m(k) of this titleor section 1395m(l) of this title and does not include screening mammography (as defined insection 1395x(jj) of this title), diagnostic mammography, or personalized prevention plan services (as defined insection 1395x(hhh)(1) of this title); and (v)does not include applicable items and services (as defined in subparagraph (A) of paragraph (21)) that are furnished on or after, by an off-campus outpatient department of a provider (as defined in subparagraph (B) of such paragraph).


42 USC § 1395l(t)()(1)(B)

Scoping language

None: Default is title Scope
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