Preventive Services
PrEP for HIV
CMS is encouraging pharmacies and other interested parties to prepare now for the expected transition of coverage from Medicare Part D to Medicare Part B for Preexposure Prophylaxis (PrEP) using antiretroviral drugs to prevent HIV. We expect to release the final National Coverage Determination (NDC) in late September 2024. Coverage under Part B will begin at that time. For more information on:
- PrEP: Visit PrEP for HIV & Related Preventive Services
- How to enroll:
Medicare covers many preventive services to keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can help keep your patients from getting certain diseases. Talk to your patients about which preventive services are right for them and how often they need them.
If you’re a person with Medicare, learn about all preventive services.
Learn more about billing for Medicare-covered preventive services:
- Shots & vaccines
- COVID-19 vaccine toolkit
- Flu shot
- Hepatitis B shot
- Pneumococcal shot
- In-Home Vaccine Administration: Additional Payment
- Medicare Benefit Policy Manual – Chapter 15: Section 50.4.4.2 – Immunizations (PDF)
- Roster Billing: COVID-19, Flu, & Pneumococcal vaccines
- Skilled Nursing Facility: Billing Medicare for Respiratory Vaccines (PDF)
- Medicare Part D Vaccines (PDF)
- Wellness visits
- Diabetes-related services
- Tests & screenings
- Bone mass measurements
- Cardiovascular disease screening tests
- Cervical cancer screenings with Human Papillomavirus (HPV) tests
- Colorectal cancer screening tests
- Glaucoma screening
- Hepatitis B screening
- Hepatitis C screening
- HIV screening
- Lung cancer screening
- Mammography screening
- Pap tests screening
- Prolonged preventive services
- Prostate cancer screening
- Screening Pap Tests & Pelvic Exams (PDF)
- Screening pelvic exams, including clinical breast exam
- Sexually transmitted infection (STI) screening
- Ultrasound Abdominal Aortic Aneurysm (AAA) screening
- Counseling & therapies
- Mental health services
- Resources