Medicare Coverage of Items and Services Furnished to Beneficiaries in Custody Under a Penal Authority ICN 908084 10/1.13

When “you” is used in this publication, we are referring to Medicare providers and suppliers.

Medicare will generally not pay for medical items and services furnished to a beneficiary who was incarcerated or in custody under a penal statute or rule at the time the items and services are furnished. This publication provides the following information about this Medicare policy:

Policy background, including the definition of individuals who are in custody (or incarcerated) under a penal statute or rule;

Determining whether a beneficiary is in custody under a penal statute or rule;

Medicare claims processing for items and services for incarcerated beneficiaries;

Exception to Medicare policy; Informational Unsolicited Response (IUR); and Resources. Read More