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

• Initial Preventive Physical Examination (IPPE) also known as the “Welcome to Medicare” visit (includes a referral for an ultrasound screening for Abdominal Aortic Aneurysm for eligible beneficiaries)
• Annual Wellness Visit (Including Personalized Prevention Plan Services) – Effective 1/1/11
• Bone Mass Measurement
• Cancer Screenings
  • Breast Cancer (mammography 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
  • Prostate (PSA blood test and Digital Rectal Exam)
• Cardiovascular Disease Screening
• Diabetes Screening
• Diabetes Self-Management Training
• Glaucoma Screening
• Human Immunodeficiency Virus (HIV) Screening
• Immunizations (Seasonal Influenza, Pneumococcal, and Hepatitis B)
• Medical Nutrition Therapy (for beneficiaries with diabetes or renal disease)
• Tobacco-Use Cessation Counseling
• Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse – Effective 10/14/11
• Screening for Depression in Adults – Effective 10/14/11
• Intensive Behavioral Therapy for Cardiovascular Disease – Effective 11/8/11
• Screening for Sexually Transmitted Infections (STIs) and High-Intensity Behavioral Counseling (HIBC) to prevent STIs - Effective 11/8/11
• Intensive Behavioral Therapy for Obesity - Effective 11/29/11

As a result of the Affordable Care Act, Medicare now covers many of these services without cost to patients, including the new Annual Wellness Visit that was created under the Affordable Care Act. (Refer to the Preventive Services Quick Reference Chart in the Downloads section below for more information.)