Which Essential Health Benefit (EHB) category covers care received on an outpatient basis without hospital admission?
Ambulatory patient services.
Ambulatory patient services constitute one of the ten mandated categories of Essential Health Benefits (EHBs) required for most plans sold on the Health Insurance Marketplace or through expanded Medicaid. This category specifically refers to medical care and treatment that an individual receives on an outpatient basis, meaning the patient is able to come to the facility for services like diagnostic testing, minor procedures, or specialist consultations and then return home the same day, without requiring an overnight stay or formal admission to a hospital setting. This contrasts directly with Hospitalization coverage, which covers inpatient care, surgery, and overnight stays. The mandate for these ten categories ensures a baseline level of comprehensive coverage addressing common medical needs.
