Preventive Services

This Medicare Learning Network® (MLN) Products Preventive Services page provides educational products for Medicare Fee-For-Service health care professionals, and their staff, information on coverage, coding, billing, reimbursement, and claim filing procedures. The following Medicare-covered preventive services and screenings are 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;
• 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; and
• Tobacco-Use Cessation Counseling Services.

Educational Products for Health Care Professionals

Please Note: The products listed here are for use by health care providers and their staff, only and are not intended for distribution to Medicare beneficiaries.

Articles

• MLN Matters Provider Education Articles Related to Medicare-covered Preventive Benefits - These are national articles for Fee-For-Service health care professionals focused on Medicare preventive services and screenings. (Go to the “Downloads” section to view this resource.)

Booklets 

(In order to view each of these booklets, scroll to the "Downloads" section and select "Preventive Services Educational Products.”)

• Cardiovascular Disease Services – This booklet is designed to provide education on cardiovascular disease services.
• Intense Behavior Therapy (IBT) for Obesity – This booklet is designed to provide education on intensive behavioral therapy for obesity.
• Preventive Immunizations – This booklet is designed to provide education on seasonal influenza, pneumococcal, and Hepatitis B vaccines.
• Providing the Annual Wellness Visit (AWV) – This booklet is designed to provide education on an annual wellness visit (AWV) which provides personalized preventive plan services (PPPS).
• Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse – This booklet is designed to provide education on screening and behavioral counseling interventions in primary care to reduce alcohol abuse.
• Screening and Diagnostic Mammography – This booklet is designed to provide education on early diagnosis and treatment of breast cancer.
• Screening for Depression – This booklet is designed to provide education on screening for depression services.
• Screening Pap Tests – This booklet is designed to provide education on screening pap tests.
• Screening Pelvic Examinations – This booklet is designed to provide education on screening pelvic examinations.

Brochures

(In order to view each of these brochures, scroll to the "Downloads" section and select "Preventive Services Educational Products.”)

• Bone Mass Measurement – This brochure is designed to provide health care professionals with an overview of Medicare's bone mass measurements (bone density studies) benefit.
• Cancer Screenings - This brochure is designed to provide education on Medicare's mammography screening, screening Pap test, pelvic screening examination, and prostate cancer screening benefits.
• Expanded Benefits - This brochure is designed to provide education on three preventive services: the Initial Preventive Physical Examination (IPPE), also known as the "Welcome to Medicare" physical exam or the "Welcome to Medicare" visit; Ultrasound Screening for Abdominal Aortic Aneurysms; and Cardiovascular Screening Blood Tests.
• Glaucoma Screening - This brochure is designed to provide education on Medicare-covered glaucoma screening.
• Human Immunodeficiency Virus (HIV) Screening – This brochure is designed to provide education on Medicare-covered Human Immunodeficiency Virus (HIV) screening.
• Tobacco-Use Cessation Counseling Services – This brochure is designed to provide education on tobacco-use cessation counseling services. It includes an overview on coverage information as well as cessation counseling sessions.

Fact Sheets

(In order to view each of these guides, scroll to the "Downloads" section and select "Preventive Services Educational Products.")

• Diabetes-Related Services – This fact sheet is designed to provide education on diabetes-related services.
• Mass Immunizers and Roster Billing – This fact sheet is designed to provide education on mass immunizers and roster billing. It includes information on simplified billing procedures for the influenza and pneumococcal vaccinations.

Guides

(In order to view each of these guides, scroll to the "Downloads" section and select "Preventive Services Educational Products.”)

• The Guide to Medicare Preventive Services Fourth Edition - This guide is designed to provide education on Medicare's Preventive benefits. It includes information on coverage, frequency, risk factors, billing and reimbursement. (March 2011)

Quick Reference Information

(In order to view each of these quick references, scroll to the "Downloads" section and select "Preventive Services Educational Products.”)

• Quick Reference Information: Medicare Immunization Billing - This chart identifies the components and elements of coding information for the influenza, pneumococcal, and hepatitis B vaccines and their administration.
• Quick Reference Information: Medicare Preventive Services - This chart identifies the components and elements of Medicare preventive services and screenings, coding requirements, eligibility, frequency parameters, and copayment/coinsurance and deductible information for each benefit.
• Errata Sheet: Quick Reference Information: Preventive Services – This educational tool contains a correction to the statutory citation that gives CMS authority to cover additional preventive services through the National Coverage Determination Process.
• Quick Reference Information: The ABCs of Providing the Annual Wellness Visit – This chart identifies the components and elements of the AWV and provides eligibility requirements, procedure codes to use when filing claims, and FAQs.
• Quick Reference Information: The ABCs of Providing the Initial Preventive Physical Examination (IPPE) – This chart identifies the components and elements of the IPPE and provides eligibility requirements, procedure codes to use when filing claims, FAQs, suggestions for preparing patients for the IPPE, and lists references for additional information.
• Quick Reference Information Resources: Medicare Preventive Services - This product is designed to provide education on Medicare-covered preventive services.  It includes the following 4 previously published charts: Quick Reference Information Preventive Services, Quick Reference Information Medicare Immunization Billing, Quick Reference Information The ABCs of the IPPE, and Quick Reference Information The ABCs of the AWV.

Other Useful Resources

• 2012-2013 Seasonal Influenza Virus Educational Products and Resources – This PDF document includes links to influenza-related MLN products for providers, as well as other online resources with useful information and tools for the 2012-2013 flu season. (Go to the “Downloads” section to view this resource.)

If you would like to contact the MLN, please e-mail us at MLN@cms.hhs.gov.