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Which services are specifically excluded from Medicare coverage under 42 CFR 411.15? Answer in under 100 words.

Under 42 CFR 411.15, Medicare excludes routine physical checkups, low vision aids, refractive eye exams, hearing aids, most immunizations, orthopedic shoes, custodial care, cosmetic surgery, most dental services, personal comfort services, services not reasonable and necessary for specified purposes, foot care, certain services to hospital patients by non-hospital entities, assistance-at-surgery in cataract operations, experimental devices, services to SNF residents by non-SNF entities, assisted suicide, home health services without claim submission, and items from non-contract suppliers in competitive bidding.
Last verified: 2026-08-26 · Sources checked: 1/1 resolving · Next scheduled review: 2026-11-24

Details / How it works

The regulation lists over a dozen categories of services excluded from Medicare coverage, with specific exceptions for certain preventive services, prosthetic lenses, immunizations (pneumococcal, hepatitis B, influenza, COVID-19), and dental services linked to covered medical procedures. Exclusions also encompass services not reasonable and necessary for diagnosis or treatment, custodial care, cosmetic surgery, and foot care, among others.

Exceptions & edge cases

Notable exceptions include: (1) routine physicals that are part of preventive services like screening mammography and annual wellness visits; (2) prosthetic lenses after cataract surgery; (3) pneumococcal, hepatitis B, influenza, and COVID-19 vaccinations; (4) dental services integral to covered medical services such as organ transplants or cancer treatment; and (5) certain implantable auditory devices like cochlear implants.

Sources

  1. [1]U.S. National Archives, Electronic Code of Federal Regulations — 42 CFR 411.15 — Particular services excluded from coverage · as of 2026-08-26

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