National HIV Testing Day - June 27

Human immunodeficiency virus (HIV) is a virus that attacks cells that assist the body's ability to fight infection. When HIV is present in the body it attacks the immune system, which makes the body less able to resist disease and infection.

Unless they are tested, patients may not know they have HIV until they get sick. Early diagnosis and treatment with anti-HIV drugs can help people with HIV stay healthy for a long time and decrease the chances of passing the virus to others. There is not a cure for HIV infections, but early detection with HIV screening will help people live healthier and longer lives.

Early treatment greatly reduces the risk of developing acquired immunodeficiency syndrome (AIDS, which is the final stage of HIV infection), having AIDS-related conditions, or dying of AIDS. Treatments includes medicines such as ART (antiretroviral therapy) to fight the infection, vaccinations against illnesses such as hepatitis B, and medicines to prevent infections that occur more easily if a person is infected with HIV.

HIV screening involves taking a blood sample and testing the sample for the presence of HIV antibodies (disease-fighting proteins) that react specifically to HIV.

The U.S. Preventive Services Task Force recommends screening for HIV for everyone aged 15 to 65; teens younger than age 15 and adults older than 65 if those individuals are at increased risk for HIV infection. "Increased risk for HIV infection" is defined in the CMS Internet Only Manual (IOM), Publication 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Part 4, Section 210.7.

Medicare will cover HIV screening for certain beneficiaries without regard to perceived risk or who are at increased risk for HIV infection, which includes anyone asking for the test or pregnant women. Medicare beneficiaries may be screened annually. Pregnant beneficiaries can be screened 3 times per pregnancy.

As a healthcare professional, help your patients get the best health care by recommending HIV screening for those with increased risk for HIV infection, or those who have made you aware of behaviors that increase their risk. Help decrease the number of people who become infected every year, and the percentage of people with HIV who are not even aware they have it.

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The A/B Medicare Administrative Contractor (MAC) Provider Outreach & Education (POE) developed this document to ensure consistent communication and education throughout the nation on a variety of topics and assist the provider and physician community with information necessary to submit claims appropriately and receive proper payment in a timely manner.

Last Updated Jun 05, 2019