US · guidance
CMS Pub. 100-04, ch. 1, § 30.1.1
Provider Charges to Beneficiaries
In the agreement/attestation statement signed by a provider, it agrees not to charge
Medicare beneficiaries (or any other person acting on a beneficiary’s behalf) for any
service for which Medicare beneficiaries are entitled to have payment made on their
behalf by the Medicare program. This includes items or services for which the
beneficiary would have been entitled to have payment made had the provider filed a
request for payment (see §50).
The provider may bill the beneficiary for the following items:
• Part A deductible;
• Part B deductible;
• First 3 pints of blood, which is called the blood deductible (if there is a charge for
blood or the blood is not replaced);
• Part B coinsurance;
• Part A coinsurance; or
• Services that are not Medicare covered services. See Chapter 30 for related
requirements.
SNFs may not require, request, or accept a deposit or other payment from a Medicare
beneficiary as a condition for admission, continued care, or other provision of services,
except as follows:
• A SNF may request and accept payment for a Part A deductible and coinsurance
amount on or after the day to which it applies.
• A SNF may request and accept payment for a Part B deductible and coinsurance
amount at the time of or after the provision of the service to which it applies.
• A SNF may not request or accept advance payment of Medicare deductible and
coinsurance amounts.
• A SNF may require, request, or accept a deposit or other payment for services if it
is clear that the services are not covered by Medicare and proper notice is
provided. See Chapter 30 for instructions about ABNs and demand bills.
• SNFs, but not hospitals, may bill the beneficiary for holding a bed during a leave
of absence if the requirements in §30.1.1.1 are met.
History
(Rev. 2921, Issued: 04-04-14, Effective: 05-05-14, Implementation: 05-05-14)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
b0532e18b2f344c239e3685ae0b33113d7053ee2d27cbfa2296c8d766611904b
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