US · guidance
CMS Pub. 100-04, ch. 30, § 130.1
Applicability of the Limitation on Liability Provision to Claims
for Ancillary, Outpatient Provider and Rural Health Clinic Services
Payable Under Part B
(Rev. 3187, Issued: 02-06-15, Effective: 03-06-15, Implementation: 03-06-15)
The following sections discuss how the limitation on liability provision is applied to
claims involving ancillary, outpatient and rural health clinic services billed to the A/B
MAC (A), where reimbursement is sought under Part B. The A/B MAC (A) determines
whether limitation on liability applies to these categories of claims when the basis for the
denial is that the services were not reasonable and necessary (under §1862(a)(l) of the
Act).
History
(Rev. 3187, Issued: 02-06-15, Effective: 03-06-15, Implementation: 03-06-15)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
5a66baa74a10efd36051477388aec8384770e5cf5d471c7f038e2addbeec7a7c
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