Medicare pays for many preventive services to keep beneficiaries healthy. Preventive services can find health problems early, when treatment works best, and can keep them from getting certain diseases. These services include exams, shots, lab tests, screenings, as well as, programs for health monitoring, and counseling and education to help them take care of their own health.
Noridian's provider portal, Endeavor, offers some preventive history as part of the beneficiary eligibility inquiry.
Medicare covers the following preventive services and screenings, subject to certain eligibility and other limitations.
- Abdominal Aortic Aneurysm Screening
- Adult Immunizations
- Annual Wellness Visit; Including Personalized Prevention Plan Services
- Bone Mass Measurements
- Cancer Screenings
- Cardiovascular Screening
- Diabetes Screening
- Diabetes Self-Management Training
- Diabetes Supplies
- Glaucoma Screening
- HIV Screening
- Influenza & Pneumonia
- Initial Preventive Physical Exam ("Welcome to Medicare" Physical Exam)
- Intensive Behavioral Therapy for Cardiovascular Disease
- Medical Nutrition Therapy (for Medicare beneficiaries with diabetes or renal disease)
- Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse
- Screening for Depression in Adults
- Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling to Prevent STIs
- Tobacco-Use Cessation Counseling Services
CMS has developed educational resources that are available for the provider community.
- CMS IOM, Publication 100-04, Chapter 18, Preventive and Screening Services - Internet Only Manual containing definition and listing of preventive and screening services.
- Preventive Services Educational Products - The CMS Medicare Learning Network ® (MLN) offers products, free of charge to view, download, print, and redistribute.
- CMS Quick Reference Information - Chart containing the name of the service, CPT/HCPCS, diagnosis, who is covered, frequency, and beneficiary payment information.
- The ABCs of Providing the Initial Preventive Physical Examination (IPPE) - This document explains the IPPE components, also known as the "Welcome to Medicare Preventive Visit," which include the beneficiary history, examination, coding, and preventive services.
- CMS Prevention General Information - This CMS website defines the preventive services and offers additional resources.
Last Updated Nov 24, 2015