CMS Pub. 100-01, ch. 3, § 20.2

In each calendar year, a cash deductible must be satisfied before payment can be made

under SMI. (See 20.4 of this chapter for exceptions.)

Calendar Year Deductible

1966 – 1972 $50

1973 – 1981 $60

1982 – 1990 $75

1991 – 2004 $100

2005 $110

2006 $124

2007 $131

2008 $135

2009 $135

2010 $155

2011 $162

2012 $140

2013 $147

2014 $147

2015 $147

2016 $166

2017 $183

2018 $183

2019 $185

2020 $198

2021 $203

2022 $233

2023 $226

2024 $240

2025 $257

Expenses count toward the deductible on the basis of incurred, rather than paid

expenses, and are based on Medicare allowed amounts. Non-covered expenses do not

count toward the deductible. Even though an individual is not entitled to Part B benefits

for the entire calendar year (i.e., insurance coverage begins after the first month of a

year or the individual dies before the last month of the year), he or she is still subject to

the full deductible for that year. Medical expenses incurred in the portion of the year

preceding entitlement to medical insurance are not credited toward the deductible.

The date of service generally determines when expenses were incurred, but expenses

are allocated to the deductible in the order in which the bills are received. Services not

subject to the deductible cannot be used to satisfy the deductible.

Pro Rata Amounts

Pro Rata Amounts

First Month Second Month

2012 $100.20 $39.80

2013 $103.95 $43.05

2014 $114.99 $32.01

2015 $114.99 $32.01

2016 $118.86 $47.14

2017 $125.73 $57.27

2018

$126.88 $56.12

2019 $133.57 $51.43

2020 $140.46 $57.54

2021 $145.31 $57.69

2022 $150.66 $82.34

2023 $154.95 $71.05

2024 $161.71 $78.29

2025 $170.32 $86.68

The Part B deductible is split into pro rata amounts. The purpose of the pro rata

amount is to provide beneficiaries who are enrolled in managed care plans the benefit

of assuming they have paid their deductible as if they were not enrolled in a managed

care plan. The pro rata amount does not apply only to just the first two months of the

year but rather for the number of months after first enrollment in a managed care plan

that is necessary to cover the Part B deductible. Each year starts the deduction for the

pro rata amount over again.