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.

CMS Prevention Communications

• Prevention Awareness Communications - Part of CMS' preventive services information program for providers includes monthly prevention awareness messages that correspond with the National Monthly Health Observances. (Go to the “Downloads” section to view this resource.)

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.
• 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.

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.
• Preventive Immunizations – This brochure is designed to provide education on Medicare's Influenza Vaccine, Pneumococcal Vaccine, and Hepatitis B Vaccine benefits.
• 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.”)

• Determining a Medicare Beneficiary's Eligibility for Medicare Preventive Services - This guide is designed to provide information on interpreting the Medicare beneficiary preventive services next eligible date data and is intended to supplement the educational materials already available for the HIQA, HIQH, HUQA, ELGA, ELGB and ELGH eligibility inquiry screens used to access Common Working File (CWF) records. (December 2007) (Available in Download Only)
• 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.
• 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.

Web-Based Training Courses

• Medicare Preventive Services Web-Based Training Courses (WBTs) - These three WBTs are designed to provide education on Medicare Preventive Services. They include coverage, coding, and payment information on each of the preventive benefits that Medicare covers. (To access the courses, scroll down to “Related Links ” and select “Web-Based Training (WBT) Courses”.

Other Useful Resources

• 2011-2012 Seasonal Influenza Season Virus Educational Products and Resources – This PDF document includes links to influenza-related educational products CMS has developed for providers, as well as other online resources with useful information and tools for the 2011-2012 influenza 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.