§ 410.155 Outpatient mental health treatment limitation.

(a) Limitation. For services subject to the limitation as specified in paragraph (b) of this section, the percentage of the expenses incurred for such services during a calendar year that is considered incurred expenses under Medicare Part B when determining the amount of payment and deductible under § 410.152 and § 410.160 of this part, respectively, is as follows:

(1) For expenses incurred in years before 2010, 62 1⁄2 percent.

(2) For expenses incurred in 2010 and 2011, 68 3⁄4 percent.

(3) For expenses incurred in 2012, 75 percent.

(4) For expenses incurred in 2013, 81 1⁄4 percent.

(5) For expenses incurred in CY 2014 and subsequent years, 100 percent.

(b) Application of the limitation—(1) Services subject to the limitation. Except as specified in paragraph (b)(2) of this section, services furnished by physicians and other practitioners, whether furnished directly or incident to those practitioners' services, are subject to the limitation if they are furnished in connection with the treatment of a mental, psychoneurotic, or personality disorder (that is, any condition identified by a diagnosis code within the range of 290 through 319) and are furnished to an individual who is not an inpatient of a hospital: