# 42 CFR § 410.3: Scope of benefits

> Federal · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/ecfr-42-410.3

## Section

- **Citation:** 42 CFR § 410.3
- **Heading:** Scope of benefits
- **Jurisdiction:** Federal
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** September 22, 2026
- **Source:** Publisher's official text
- **Location:** Title 42—Public Health > CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER B—MEDICARE PROGRAM > PART 410—SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS > Subpart A—General Provisions

## Text

(a) Covered services. The SMI program helps pay for the following:
(1) Medical and other health services such as physicians' services, outpatient services furnished by a hospital or a CAH, diagnostic tests, outpatient physical therapy and speech pathology services, rural health clinic services, Federally qualified health center services, IHS, Indian tribe, or tribal organization facility services, and outpatient renal dialysis services.
(2) Services furnished by ambulatory surgical centers (ASCs), HHAs, CORFs, and partial hospitalization services and intensive outpatient services provided by CMHCs.
(3) Other medicial services, equipment, and supplies that are not covered under Medicare Part A hospital insurance.
(b) Limitations on amount of payment. (1) Medicare Part B does not pay the full reasonable costs or charges for all covered services. The beneficiary is responsible for an annual deductible and a blood deductible and, after the annual deductible has been satisfied, for coinsurance amounts specified for most of the services.
(2) Specific rules on payment are set forth in subpart I of this part.
[51 FR 41339, Nov. 14, 1986, as amended at 57 FR 24981, June 12, 1992; 58 FR 30668, May 26, 1993; 59 FR 6577, Feb. 11, 1994; 66 FR 55328, Nov. 1, 2001; 75 FR 73613, Nov. 29, 2010; 88 FR 82177, Nov. 22, 2023]

## Nearby sections

- [42 CFR § 410.1 § 410.1 Basis and scope.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.1.md)
- [42 CFR § 410.2 § 410.2 Definitions.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.2.md)
- [42 CFR § 410.3 § 410.3 Scope of benefits.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.3.md)
- [42 CFR § 410.5 § 410.5 Other applicable rules.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.5.md)
- [42 CFR § 410.10 § 410.10 Medical and other health services: Included services.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.10.md)
- [42 CFR § 410.12 § 410.12 Medical and other health services: Basic conditions and limitations.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.12.md)
- [42 CFR § 410.14 § 410.14 Special requirements for services furnished outside the United States.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.14.md)
- [42 CFR § 410.15 § 410.15 Annual wellness visits providing Personalized Prevention Plan Services: Conditions for and limitations on coverage.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.15.md)
- [42 CFR § 410.16 § 410.16 Initial preventive physical examination: Conditions for and limitations on coverage.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.16.md)
- [42 CFR § 410.17 § 410.17 Cardiovascular disease screening tests.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.17.md)
- [42 CFR § 410.18 § 410.18 Diabetes screening tests.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.18.md)
- [42 CFR § 410.19 § 410.19 Ultrasound screening for abdominal aortic aneurysms: Condition for and limitation on coverage.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.19.md)
- [42 CFR § 410.20 § 410.20 Physicians' services.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.20.md)
- [42 CFR § 410.21 § 410.21 Limitations on services of a chiropractor.](https://www.frixlaw.com/law-library/statutes/ecfr-42-410.21.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/ecfr-42-410.3. Check the current official text before relying on it. Not legal advice.