We can agree to disagree.
Medicare Benefit Policy Manual;
Chapter 1 - Inpatient Hospital Services Covered Under Part A
Section 1 – Definition of Inpatient Hospital Services
B. Inpatient hospital services does not include the following types of services:
3. Physician services that meet the requirements of 42 CFR 415.102(a) for payment on a fee schedule basis.
4. Physician assistant services, as defined in §1861(s)(2)(K)(i) of the Act.
5. Nurse practitioner and clinical nurse specialist services, as defined in §1861(s)(2)(K)(ii) of the Act.
6. Certified nurse mid-wife services, as defined in §1861(gg) of the Act.
7. Qualified psychologist services, as defined in §1861(ii) of the Act.
8. Services of an anesthetist, as defined in 42 CFR 410.69.
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2016 Medicare & You
Hospital care (inpatient care)
If you have Part B, it generally covers 80% of the Medicare-approved amount for doctor’s services you get while you’re in a hospital.
Reference:
https://www.medicare.gov/Pubs/pdf/10050.pdf
Medicare Basics
Everyone with Medicare can get this inpatient hospital care:
• General nursing
• Semi-private room
• Doctor’s services you get while you’re in a hospital (if you have Part B).
• Meals and supplies
Reference:
https://www.medicare.gov/Pubs/pdf/11034.pdf
Situation: You're formally admitted to the hospital with a doctor's order.
Part A pays: Your inpatient hospital stay
Part B pays: Your doctor services
Reference:
https://www.medicare.gov/what-medicare-covers/part-a/inpatient-or-outpatient.html
Part B deductible & coinsurance
You pay $166 per year for your Part B deductible. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient).
Reference:
https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html
Medicare 2016 costs at a glance
Part B deductible and coinsurance: $166 per year. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient.
Reference:
https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html
Under the Medicare Fee-for-Service program, hospitals and physicians are paid separately for care provided in hospitals under Part A and Part B, respectively, which adds to the misalignment between the incentives facing hospitals and those facing physicians.
Reference:
https://innovation.cms.gov/files/reports/dra5007-report-to-congress.pdf