Treatment of Drug Abuse (Chemical Dependency)

Medicare covers inpatient detoxification and rehabilitation for drug substance abuse when medically necessary and covers hospital outpatient department treatment for patients discharged from inpatient stays or those who require treatment without inpatient-level services. Coverage is limited to services that are reasonable and necessary and subject to Medicare's general exclusions and the same outpatient hospital rules; determinations of necessity, level of care, and treatment length are made by A/B MACs (with QIO determinations binding where applicable).

"Medicare covers hospital inpatient detoxification and/or rehabilitation for drug (substance) abuse when the service is medically necessary."

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