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Prevention - General Information

CMS is committed to promoting the appropriate use of Medicare preventive benefits.  Medicare now covers a broad range of services to prevent disease, detect disease early when it is most treatable and curable, and manage disease so that complications can be avoided.  

Unfortunately, older adults are not receiving all recommended preventive services, even with frequent visits to physician offices. Reasons for this vary, but highlight the opportunity to improve preventive care for older adults.

CMS recognizes the crucial role that health care providers play in providing and educating Medicare beneficiaries about potentially life-saving preventive services and screenings. While Medicare now pays for more preventive benefits, many Medicare beneficiaries do not fully realize that using preventive services and screenings can help them live longer, healthier lives. As a health care professional, you can help your Medicare patients understand the importance of disease prevention, early detection, and lifestyle modifications that support a healthier life.

The CMS Prevention section provides access to information, resources, and tools to help support the delivery and awareness of preventive services and screenings covered by Medicare, and provide health care providers and suppliers with the information needed to effectively file claims for services provided to Medicare beneficiaries.

Preventive Services and Screenings Covered by Medicare

  • Abdominal Aortic Aneurysm Screening
  • Alcohol Misuse Screening and Behavioral counseling Intervention in Primary Care
  • Annual Wellness Visit (Including Personalized Prevention Plan Services)
  • Bone Mass Measurements
  • Cancer Screenings
    • Breast Cancer (mammograms and clinical breast exam)
    • Cervical and Vaginal Cancer (pap test and pelvic exam [includes the clinical breast exam])
    • Colorectal Cancer
      • Fecal Occult Blood Test
      • Flexible Sigmoidoscopy
      • Colonoscopy
      • Barium Enema
      • Cologuard™ multi-target stool DNA test, effective 10/9/14
    • Screening for Lung Cancer with Low Dose Computed Tomography, effective 2/5/15
    • Prostate (PSA blood test and Digital Rectal Exam)
  • Cardiovascular Disease Screening
  • Depression Screening in Adults
  • Diabetes Screening
  • Diabetes Self-Management Training
  • Glaucoma Screening
  • Hepatitis C Screening
  • Human Immunodeficiency Virus (HIV) Screening
  • Immunizations (Seasonal Influenza, Pneumococcal, and Hepatitis B)
  • Initial Preventive Physical Examination (IPPE) (also commonly referred to as the “Welcome to Medicare” Preventive Visit)
  • Intensive Behavioral Therapy for Cardiovascular Disease
  • Intensive Behavioral Therapy for Obesity
  • Medical Nutrition Therapy (for beneficiaries with diabetes or renal disease)
  • Sexually Transmitted Infections (STIs) Screening and High-Intensity Behavioral Counseling (HIBC) to prevent STIs
  • Tobacco-Use Cessation Counseling

As a result of the Affordable Care Act, Medicare now covers many of these services without cost to patients, including the Annual Wellness Visit that was created under the Affordable Care Act. (Refer to the Downloads section below and the navigation tabs on the left for information on coverage, coding, billing and more.)