Q&A: Applying Medicare's deductible to blood products

Q: How is the Medicare Part A and B deductible applied to blood products?

A: Medicare’s rules on how to apply the Part A and Part B blood deductible are set out in regulations at 42 C.F.R. § 409.87 and § 410.161, respectively. Medicare does not pay for the first three units of whole blood or units of packed red cells that a beneficiary receives during a calendar year either as an inpatient of a hospital, critical access hospital (CAH), or skilled nursing facility (SNF); or on an outpatient basis under Part B. Packed red cells refer to the red blood cells that remain after plasma is separated from whole blood. A unit of packed red cells is treated as the equivalent of a unit of whole blood. The blood deductible does not apply to other blood components such as platelets, fibrinogen, plasma, gamma globulin, and serum albumin; or to the cost of processing, storing, and administering blood, but is in addition to other applicable Part A or B beneficiary cost sharing amounts.

For more information, see "Note from the instructor: Coverage, billing, and payment for blood products and related services under Part B," by Judith L. Kares, JD.