42 U.S.C. § 1395k
Scope of benefits; definitions
United States · Title 42 — THE PUBLIC HEALTH AND WELFARE · Status: effective
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- Citation
- 42 U.S.C. § 1395k, Scope of benefits; definitions, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/477265
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Full text
The benefits provided to an individual by the insurance program established by this part shall consist of—
entitlement to have payment made on his behalf (subject to the provisions of this part) for—
medical and other health services (other than items described in subparagraph (G) or subparagraph (I)) furnished by a provider of services or by others under arrangement with them made by a provider of services, excluding—
physician services except where furnished by—
facility services furnished in connection with surgical procedures specified by the Secretary—
pursuant to section 1395l(i)(1)(B) of this title and performed by a physician, described in paragraph (1), (2), or (3) of section 1395x(r) of this title, in his office, if the Secretary has determined that—
For definitions of “spell of illness”, “medical and other health services”, and other terms used in this part, see section 1395x of this title.
Legislative history
The public laws that enacted or amended this section. Tallies are for the whole bill as it passed each chamber — often an omnibus covering far more than this provision — not a vote on this section alone. The law that originally enacted this section predates the public laws loaded here, so only later amendments are listed.
- An Act to amend titles XVIII and XIX of the Social Security Act to provide payment for rural health clinic services, and for other purposes.House: no recorded tallySenate: no recorded tally
- Omnibus Reconciliation Act of 1980House: no recorded tallySenate: no recorded tally
- Tax Equity and Fiscal Responsibility Act of 1982House: no recorded tallySenate: no recorded tally
- Deficit Reduction Act of 1984House: no recorded tallySenate: no recorded tally
- Omnibus Budget Reconciliation Act of 1986House: no recorded tallySenate: no recorded tally
- Omnibus Budget Reconciliation Act of 1987House: no recorded tallySenate: no recorded tally
- Medicare Catastrophic Coverage Act of 1988House: no recorded tallySenate: no recorded tally
- Medicare Catastrophic Coverage Repeal Act of 1989House: no recorded tallySenate: no recorded tally
- Omnibus Budget Reconciliation Act of 1989House: no recorded tallySenate: 87–7
- Omnibus Budget Reconciliation Act of 1990
- Balanced Budget Act of 1997
- Consolidated Appropriations Act, 2000
- Consolidated Appropriations Act, 2001
- Medicare Improvements for Patients and Providers Act of 2008House: 355–59Senate: no recorded tally
- To extend the Generalized System of Preferences, and for other purposes.
- Consolidated Appropriations Act, 2023House: 225–201Senate: no recorded tally