Preventive Services List: I-Z - JE Part B

Preventive Services List: I-Z

Medicare covers the following preventive services and screenings, subject to certain eligibility and other limitations.

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Influenza Virus Vaccine and Administration

To learn more on billing influenza, visit the Influenza and Pneumonia Billing webpage.

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	90662, 90672, 90674, 90682, 90685, 90686, 90687, 90688, 90694, 90756 - Influenza Virus Vaccine (effective 08/01/2022 - 07/31/2023) G0008 - Administration of influenza virus vaccine
Frequency	Once per influenza season (additional flu shots are covered if medically necessary)
Diagnosis Code	Z23 - Encounter for immunization
Coverage	All Medicare beneficiaries
Payment	Copayment/coinsurance waived; Deductible waived G0008 allows $30 (2022)
Resources	Influenza and Pneumonia Billing CMS Internet Only Manual (IOM), Publication 100-02, Chapter 15, Section 50.4.4.2 CMS IOM, Publication 100-04, Chapter 18, Section 10 CMS Medicare Learning Network (MLN) Matters Special Edition (SE)19022 - 2019-2020 Influenza (Flu) Resources for Health Care Professionals CMS MLN Publications CMS Preventive Services FAQ CMS Roster Billing for Mass Immunizers
Roster Billing	Simplifies claims by allowing mass immunizers to submit one claim form with a list of several immunized beneficiaries on the same date Use Medicare Beneficiary Identifiers (MBIs) to check eligibility and submit claims
Noridian Medicare Portal	No

Initial Preventive Physical Examination (IPPE)

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	G0402 - IPPE G0403 - EKG for IPPE G0404 - EKG tracing for IPPE G0405 - EKG interpret & report for IPPE
Frequency	Once in a lifetime and must be furnished no later than 12 months after effective date of first Medicare Part B coverage period
Coverage	All new Medicare beneficiaries within first 12 months of their first Medicare Part B coverage period Performed by Physician, Physician Assistant (PA), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS)
Payment	G0402 - Copayment/coinsurance waived; Deductible waived G0403, G0404 and G0405 - Copayment/coinsurance applies; Deductible applies
Resources	IPPE and AWV CMS IOM, Publication 100-04, Chapter 18, Section 80 CMS Preventive Services FAQ MLN Medicare Wellness Visits Educational Tool
Noridian Medicare Portal	Yes - G0402, G0403, G0404, G0405

Intensive Behavioral Therapy (IBT) for Cardiovascular Disease

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	G0446 - Annual, face-to-face intensive behavioral therapy for cardiovascular disease
Frequency	Annually
Coverage	Beneficiaries competent at time of counseling; and Furnished by qualified primary care physician or other primary care practitioner and in primary care setting
Therapy Components	Encouraging aspirin use for men ages 45-79 and women ages 55-79 High blood pressure screening for adults ages 18 and older; and Intensive behavioral counseling to promote a healthy diet for adults with hypertension, advancing age, and other known risk factors for cardiovascular- and diet-related chronic disease
Counseling Requirements	Counseling is to be completed based on Five As Approach Assess: Ask about or assess behavioral health risks and factors affecting choice of behavior change goals/methods Advise: Give clear, specific, and personalized behavior change advice, including information about personal health harms and benefits Agree: Collaboratively select appropriate treatment goals and methods based on patient's interest in and willingness to change behavior Assist: Using behavior change techniques (self-help and/or counseling), aid patient in achieving agreed upon goals by acquiring the skills, confidence, and social/environmental supports for behavior change, supplemented with adjunctive medical treatments when appropriate Arrange: Schedule follow-up contacts (in person or by telephone) to provide ongoing assistance/support and to adjust treatment plan as needed, including referral to more intensive or specialized treatment
Payment	Copayment/coinsurance waived; Deductible waived
Resources	CMS IOM, Publication 100-04, Chapter 18, Section 160 CMS National Coverage Determination (NCD) 210.11 CMS Preventive Services FAQ
Noridian Medicare Portal	Yes - G0446

Intensive Behavioral Therapy (IBT) for Obesity

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	G0447 - Face-to-face behavioral counseling for obesity, 15 minutes G0473 - Face-to-face behavioral counseling for obesity, group (two–10), 30 minutes
Frequency	First month: One face-to-face visit every week Months two - six: One face-to-face visit every other week Months seven - 12: One face-to-face visit every month if certain requirements are met Notes: At the six-month visit, reassessment of obesity and determination of amount of weight loss must be performed To be eligible for additional face-to-face visits occurring once a month for additional six months, Medicare beneficiaries must have lost at least three kg For Medicare beneficiaries who do not achieve weight loss of at least three kg during first six months, reassessment of their readiness to change and Body Mass Index (BMI) is appropriate after additional six-month period
Diagnosis Code	Z68.30 - Body mass index 30.0-30.9, adult Z68.31 - Body mass index 31.0-31.9, adult Z68.32 - Body mass index 32.0-32.9, adult Z68.33 - Body mass index 33.0-33.9, adult Z68.34 - Body mass index 34.0-34.9, adult Z68.35 - Body mass index 35.0-35.9, adult Z68.36 - Body mass index 36.0-36.9, adult Z68.37 - Body mass index 37.0-37.9, adult Z68.38 - Body mass index 38.0-38.9, adult Z68.39 - Body mass index 39.0-39.9, adult Z68.41 - Body mass index 40.0-44.9, adult Z68.42 - Body mass index 45.0-49.9, adult Z68.43 - Body mass index 50.0-59.9, adult Z68.44 - Body mass index 60.0-69.9, adult; or Z68.45 - Body mass index 70 or greater, adult
Coverage	Obesity (BMI = 30 kilograms per meter squared) Competent and alert at time counseling is provided Counseling furnished by qualified primary care physician or other primary care practitioner in primary care setting
Counseling Requirements	Counseling is to be completed based on Five As Approach Assess: Ask about or assess behavioral health risks and factors affecting choice of behavior change goals/methods Advise: Give clear, specific, and personalized behavior change advice, including information about personal health harms and benefits Agree: Collaboratively select appropriate treatment goals and methods based on patient's interest in and willingness to change behavior Assist: Using behavior change techniques (self-help and/or counseling), aid patient in achieving agreed upon goals by acquiring skills, confidence, and social/environmental supports for behavior change, supplemented with adjunctive medical treatments when appropriate Arrange: Schedule follow-up contacts (in person or by telephone) to provide ongoing assistance/support and to adjust treatment plan as needed, including referral to more intensive or specialized treatment
Payment	Copayment/coinsurance waived; Deductible waived
Resources	CMS IOM, Publication 100-04, Chapter 18, Section 200 CMS CD 210.12 CMS Preventive Services FAQ
Noridian Medicare Portal	Yes - G0447 and G0473

Lung Cancer Screening

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	G0296 - Counseling visit to discuss need for lung cancer screening using low dose CT scan G0297 - Low dose CT scan for lung cancer screening (Deleted after 12/31/2020) 71271 - Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) (Effective 1/1/2021)
Frequency	Annually First year: Before first screening, beneficiary must receive counseling and shared decision making visit (HCPCS G0296) Subsequent years: Beneficiary must receive written order furnished during appropriate visit with physician or non-physician practitioner. Counseling and shared decision-making optional. If the provider elects to provide counseling in subsequent years, include all counseling requirements indicated below.
Diagnosis Code	F17.210-F17.219 - Nicotine dependence Z87.891 - Personal history of nicotine dependence
Coverage	Beneficiary must meet all of the following eligibility criteria: Age 50 - 77 years; Asymptomatic (no signs or symptoms of lung cancer); Tobacco smoking history of at least 20 pack-years (1 pack-year = smoking 1 pack per day for 1 year, 1 pack = 20 cigarettes); Current smoker or one who has quit smoking within last 15 years; Written order received for lung cancer screening with low dose computed tomography Written orders must be documented in medical record and include: Beneficiary date of birth; Actual pack-year smoking history (number); Current smoking status and for former smokers, number of years since quitting smoking; Statement that beneficiary is asymptotic, doesn't show signs or symptoms of lung cancer; and National Provider Identifier (NPI) of ordering practitioner
Couseling Requirements	Before the beneficiary's first lung cancer low dose CT screening, the beneficiary must receive a counseling and shared decision-making visit that meets all of the following criteria and is appropriately documented in the medical record: Determination of beneficiary eligibility including age, absence of signs or symptoms of lung cancer, a specific calculation of cigarette smoking pack-years; and if a former smoker, number of years since quitting Shared decision making, including use of one or more decision aids, to include benefits and harms of screening, follow-up diagnostic testing, over-diagnosis, false positive rate, and total radiation exposure Counseling on importance of adherence to annual screenings, impact of comorbidities and ability or willingness to undergo diagnosis and treatment Counseling on importance of maintaining cigarette smoking abstinence if a former smoker; or importance of smoking cessation if current smoker and, if appropriate, furnishing of information about tobacco cessation interventions If appropriate, furnishing of a written order for lung cancer screening Subsequent annual lung cancer low dose CT screenings must include a written order. If the provider or non-physician practitioner elects to provide lung cancer screening counseling for the subsequent screening, all of the criteria from the initial counseling (above) must be documented.
Payment	Copayment/coinsurance waived; Deductible waived
Resources	CMS IOM, Publication 100-04, Chapter 18, Section 220 CMS NCD 210.14 CMS Preventive Services FAQ???????
Noridian Medicare Portal	Yes - G0297/71271

Medical Nutrition Therapy (MNT)

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	97802 - MNT; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes 97803 - MNT; re-assessment and intervention, individual, face-to-face with the patient each 15 minutes 97804 - MNT; group (two or more individual(s)), each 30 minutes G0270 - MNT reassessment and subsequent intervention(s) for change in diagnosis, medical condition or treatment regimen, individual, each 15 minutes G0271 - MNT reassessment and subsequent intervention(s) for change in diagnosis, medical condition or treatment regimen, group (two or more), each 30 minutes
Frequency	First year: Three hours of one-on-one counseling Subsequent years: Two hours
Coverage	Beneficiary must meet all of the following: Referral received from treating physician; and Diagnosed with diabetes or renal disease or has received kidney transplant within last three years Service provided by registered dietitian or nutrition professional
Payment	Copayment/coinsurance waived; Deductible waived
Resources	Diabetic, Diabetes Self-Management Training (DSMT) and MNT Services CMS IOM, Publication 100-04, Chapter 4, Section 300 CMS NCD 180.1 CMS Preventive Services FAQ
Noridian Medicare Portal	No

Monkeypox and Smallpox Vaccines and Administration

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	90611 - Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 mL dosage, suspension, for subcutaneous use 90622 - Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 mL dosage, for percutaneous use 90471 - Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid) 90472 - each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure)
Payment	When the government provides vaccines at no cost, only bill for the vaccine administration. Beneficiary cost sharing will apply to the administration of the vaccine.
Resources	CMS MLN Connects August 11, 2022

Pneumococcal Vaccine and Administration

To learn more on billing pneumococcal, visit the Influenza and Pneumonia Billing webpage.

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	90670 - Pneumococcal Conjugate vaccine 90732 - Pneumococcal polysaccharide vaccine G0009 - Administration
Frequency	Initial vaccine to beneficiaries who never received vaccine under Medicare Part B Different, second vaccine one year after first vaccine was administered
Diagnosis Code	Z23 - Encounter for immunization
Coverage	All Medicare beneficiaries are eligible
Payment	Copayment/coinsurance waived; Deductible waived G0009 allows $30 (2022)
Resources	Influenza and Pneumonia Billing CMS IOM, Publication 100-02, Chapter 15, Section 50.4.4.2 CMS IOM, Publication 100-04, Chapter 18, Section 10 CMS MLN Publications CMS Preventive Services FAQ CMS Roster Billing for Mass Immunizers
Noridian Medicare Portal	Yes. HCPCS codes 90670 and 90732 (Pneumococcal Vaccines) will display up to 10 previous dates of service and with the rendering NPI. These codes will only be viewable if the beneficiary has Medicare Part B coverage.

Prolonged Preventive Service

Effective for claims with dates of service on or after 1/1/2018, prolonged preventive services will be payable by Medicare when billed as an add-on to an applicable preventive service that is payable from the Medicare physician fee schedule, and both deductible and coinsurance do not apply. G0513 and G0514 for prolonged preventive services was added as part of 1/1/2018, HCPCS update.

When an approved preventive service requires a prolonged period of direct-patient contact, beyond the suggested timeframe, one of the approved codes for preventive prolonged care maybe added. G0513 represents the first additional 30 minutes of time and G0514 represents each additional 30 minutes beyond the time of G0513. To meet the 30-minute expectation, you must spend at least 15 minutes of time and G0514 may not be added until the first full 30 minutes has been completed.

Timeframes for these services are as follows:

Less than 15 minutes is not reported separately.
G0513 x 1: 15-44 minutes
G0513 x 1 and + G0514 x 1: 45-74 minutes (45 minutes-1 hour 14 minutes)
G0513 x 1 and + G0514 x 2: 75-104 minutes (1 hour 15 minutes-1 hour 44 minutes)
G0513 x 1 and + G0514 x 3: 105-134 minutes (1 hour 45 minutes-2 hours 14 minutes)

The medical record must include information to support the medical necessity of this additional time; there must be a clinically valid reason for this extra use of time in performing the preventive service. Please note the additional time may only be spent by the provider performing and billing the preventive service; these services are not subject to incident to billing. We would not expect the use of these codes to be routine or frequent in any given practice; the codes represent relatively unusual circumstances requiring the provider to spend a prolonged period of time in direct-patient contact.

Medicare coverage and frequency varies according to the individual Medicare preventive service.

Resources

CMS MLN Matters Article (MM)10181 - Replacement of Mammography HCPCS Codes, Waiver of Coinsurance and Deductible for Preventive and Other Services, and Addition of Anesthesia and Prolonged Preventive Services
CMS IOM, Publication 100-04, Chapter 18, Section 240

Prostate Cancer Screening

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	G0102 - Digital Rectal Exam (DRE) G0103 - Prostate Specific Antigen (PSA) test
Frequency	Annually
Diagnosis Code	Z12.5 - Encounter for screening for malignant neoplasm of prostate
Coverage	Male beneficiaries aged 50 and older Coverage begins day after 50th birthday G0102 bundled into covered evaluation and management service when furnished on same day
Payment	G0102 - Copayment/coinsurance applies; Deductible applies G0103 - Copayment/coinsurance waived; Deductible waived
Resources	CMS IOM, Publication 100-04, Chapter 18, Section 50 CMS NCD 210.1 CMS Preventive Services FAQ
Noridian Medicare Portal	Yes - G0103

Screening Mammography

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	77063 - Screening digital breast tomosynthesis; bilateral (List separately in addition to code for primary procedure) (Use this as an add-on code to G0202 when tomosynthesis is used in addition to 2-D mammography) 77067 - Screening mammography, bilateral (2-view film study of each breast) (Effective 01/01/18) G0202 - Screening mammography, producing direct 2-D digital image, bilateral, all views (Valid prior to 01/01/18)
Frequency	Women aged 35 - 39: One baseline Women 40 and over: Annually
Diagnosis Code	Z12.31 - Encounter for screening mammogram for malignant neoplasm of breast
Coverage	All females aged 35 and older
Facilities	Must be certified by Food and Drug Administration (FDA) Cannot release x-rays for interpretation to physicians not approved under certification number unless: Patient requested transfer for second opinion Patient moved to another part of country where next screening mammography will be performed
Payment	Copayment/coinsurance waived; Deductible waived
Resources	CMS Frequently Asked Questions CMS IOM, Publication 100-02, Chapter 15, Section 280.3 CMS IOM, Publication 100-04, Chapter 18, Section 20 CMS NCD 220.4 CMS Preventive Services FAQ
Noridian Medicare Portal	Yes - 77057 and G0202

Screening Pap Tests

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	G0123, G0124, G0141, G0143, G0144, G0145, G0147, G0148 - Screening cytopathology, cervical or vaginal P3000 - Screening Pap smear by technician under physician supervision P3001 - Screening Pap smear requiring interpretation by physician Q0091 - Screening Pap smear; obtaining, preparing and conveyance to lab
Frequency	Annually if at high risk for developing cervical or vaginal cancer or childbearing age with abnormal Pap test within past three years High risk factors: Early onset of sexual activity Multiple sexual partners History of sexually transmitted disease Fewer than three negative or any pap smears within previous seven years DES (diethylstilbestrol) exposed daughters of women who took DES during pregnancy Every two years for women at normal risk
Diagnosis Code	High Risk Z72.51 - High risk heterosexual behavior Z72.52 - High risk homosexual behavior Z72.53 - High risk bisexual behavior Z77.21 - Contact with and (suspected) exposure to potentially hazardous body fluids Z77.22 - Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic) Z77.9 - Contact with and (suspected) exposures hazardous to health Z91.89 - Other specified personal risk factors, not elsewhere classified Z92.89 - Personal history of other medical treatment Low Risk Z01.411 - Encounter for gynecological examination (general) (routine) with abnormal findings Z01.419 - Encounter for gynecological examination (general) (routine) without abnormal findings Z12.4 - Encounter for screening for malignant neoplasm of cervix Z12.72 - Encounter for screening for malignant neoplasm of vagina Z12.79 - Encounter for screening for malignant neoplasm of other genitourinary organs Z12.89 - Encounter for screening for malignant neoplasm of other sites
Coverage	All female Medicare beneficiaries Pap test and pelvic exam can be performed during same encounter Ordered by Physician, Certified Nurse Midwife (CNM), PA, NP, CNS Pap test and Pelvic exam can be performed during same encounter
Payment	Copayment/coinsurance waived; Deductible waived
Resources	CMS IOM, Publication 100-02, Chapter 15, Section 280.4 CMS IOM, Publication 100-04, Chapter 18, Section 30 CMS NCD 210.2 CMS Preventive Services FAQ CMS Screening Pap Tests and Pelvic Examinations
Noridian Medicare Portal	Yes - G0123, G0143, G0144, G0145, G0147, G0148, P3000 and Q0091

Screening Pelvic Examinations

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	G0101 - Cervical or vaginal cancer screening; pelvic and clinical breast examination
Frequency	Annually if at high risk for developing cervical or vaginal cancer or childbearing age with abnormal Pap test within past three years High risk factors: Early onset of sexual activity Multiple sexual partners History of sexually transmitted disease Fewer than three negative or any pap smears within previous seven years DES (diethylstilbestrol) exposed daughters of women who took DES during pregnancy Every two years for women at normal risk
Coverage	All female Medicare beneficiaries Pelvic exam and Pap test can be performed during same encounter
Exam Requirements	Must include seven (7) of the 11: Inspection and palpation of breasts for masses or lumps, tenderness, symmetry, or nipple discharge Digital rectal examination including sphincter tone, presence of hemorrhoids, and rectal masses Pelvic examination (with or without specimen collection for smears and cultures) including: External genitalia (for example, general appearance, hair distribution, or lesions) Urethral meatus (for example, size, location, lesions, or prolapse). Urethra (for example, masses, tenderness, or scarring) Bladder (for example, fullness, masses, or tenderness) Vagina (for example, general appearance, estrogen effect, discharge lesions, pelvic support, cystocele, or rectocele) Cervix (for example, general appearance, lesions, or discharge) Uterus (for example, size, contour, position, mobility, tenderness, consistency, descent, or support) Adnexa/parametria (for example, masses, tenderness, organomegaly, or nodularity) Anus and perineum
Diagnosis Code	High Risk Z72.51 - High risk heterosexual behavior Z72.52 - High risk homosexual behavior Z72.53 - High risk bisexual behavior Z77.29 - Contact with and (suspected) exposure to other hazardous substances Z77.9 - Contact with and (suspected) exposures hazardous to health Z91.89 - Other specified personal risk factors, not elsewhere classified Z92.89 - Personal history of other medical treatment Low Risk Z01.411 - Encounter for gynecological examination (general) (routine) with abnormal findings Z01.419 - Encounter for gynecological examination (general) (routine) without abnormal findings Z12.4 - Encounter for screening for malignant neoplasm of cervix Z12.72 - Encounter for screening for malignant neoplasm of vagina Z12.79 - Encounter for screening for malignant neoplasm of other genitourinary organs Z12.89 - Encounter for screening for malignant neoplasm of other sites
Payment	Copayment/coinsurance waived; Deductible waived
Resources	CMS IOM, Publication 100-04, Chapter 18, Section 40 CMS NCD 210.2 CMS Preventive Services FAQ CMS Screening Pap Tests and Pelvic Examinations
Noridian Medicare Portal	Yes - G0101

Sexually Transmitted Infections (STIs) Screening and High Intensity Behavioral Counseling (HIBC) to Prevent STIs

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	86631, 86632, 87110, 87270, 87320, 87490, 87491, 87810 - Chlamydia 87590, 87591, 87850 - Neisseria gonorrhoeae 87800 - Infectious agent detection by nucleic acid, multiple organisms; direct probe(s) technique 86592 - Syphilis test, non-treponemal antibody; qualitative 86593 - Syphilis test, non-treponemal, quantitative 86780 - Treponema pallidum 87340, 87341 - Hepatitis B (hepatitis B surface antigen) G0445 - Semiannual high intensity behavioral counseling to prevent STIs, individual, face-to-face, includes education skills training and guidance on how to change sexual behavior, 30 minutes
Frequency	One annual occurrence of screening for chlamydia, gonorrhea, and syphilis in women at increased risk who are not pregnant One annual occurrence of screening for syphilis in men at increased risk Up to two occurrences per pregnancy of screening for chlamydia and gonorrhea in pregnant women who are at increased risk for STIs and continued increased risk for the second screening One occurrence per pregnancy of screening for syphilis in pregnant women; up to two additional occurrences in the third trimester and at delivery if at continued increased risk for STIs One occurrence per pregnancy of screening for hepatitis B in pregnant women; one additional occurrence at delivery if at continued increased risk for STIs Up to two 20-30 minute, face-to-face HIBC sessions annually
Diagnosis Code	Z11.3 - Encounter for screening for infections with a predominantly sexual mode of transmission Z72.51 - High risk heterosexual behavior Z72.52 - High risk homosexual behavior Z72.53 - High risk bisexual behavior Z72.89 - Other problems related to lifestyle Z34.00 - Encounter for supervision of normal first pregnancy, unspecified trimester Z34.01 - Encounter for supervision of normal first pregnancy, first trimester Z34.02 - Encounter for supervision of normal first pregnancy, second trimester Z34.03 - Encounter for supervision of normal first pregnancy, third trimester Z34.80 - Encounter for supervision of other normal pregnancy, unspecified trimester Z34.81 - Encounter for supervision of other normal pregnancy, first trimester Z34.82 - Encounter for supervision of other normal pregnancy, second trimester Z34.83 - Encounter for supervision of other normal pregnancy, third trimester Z34.90 - Encounter for supervision of normal pregnancy, unspecified, unspecified trimester Z34.91 - Encounter for supervision of normal pregnancy, unspecified, first trimester Z34.92 - Encounter for supervision of normal pregnancy, unspecified, second trimester Z34.93 - Encounter for supervision of normal pregnancy, unspecified, third trimester O09.90 - Supervision of high risk pregnancy, unspecified, unspecified trimester O09.91 - Supervision of high risk pregnancy, unspecified, first trimester O09.92 - Supervision of high risk pregnancy, unspecified, second trimester; or O09.93 - Supervision of high risk pregnancy, unspecified, third trimester
Coverage	Beneficiaries must meet all of the following criteria: Sexually active adolescents and adults at increased risk for STIs Referred by primary care provider and provided by Medicare-eligible primary care provider in primary care setting
Payment	Copayment/coinsurance waived; Deductible waived
Resources	CMS IOM, Publication 100-04, Chapter 18, Section 170 CMS NCD 210.10 CMS Preventive Services FAQ
Noridian Medicare Portal	No

Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)

Category	Coverage and Benefit Resources
HCPCS/CPT Codes	76706 - Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA)
Frequency	Once in a lifetime
Coverage	Beneficiaries must meet both of the following criteria: Certain risk factors for AAA Family history Male between ages of 65 and 75 who smoked at least 100 cigarettes during his lifetime Manifests other risk factors Receive referral from physician, physician assistant, nurse practitioner, or clinical nurse specialist
Payment	Copayment/coinsurance waived; Deductible waived
Resources	CMS IOM, Publication 100-04, Chapter 18, Section 110 CMS Preventive Services FAQ
Noridian Medicare Portal	Yes - 76706

Resources

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.
CMS Prevention General Information - This CMS website defines the preventive services and offers additional resources.
CMS Preventive Services Educational Products - The CMS Medicare Learning Network ® (MLN) offers products, free of charge to view, download, print, and redistribute.

Last Updated Mon, 21 Nov 2022 21:57:05 +0000

Jurisdiction E - Medicare Part B

Preventive Services List: I-Z - JE Part B

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