Preventive Care Services for:
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Adults
Assessment, Screening and Counseling Recommendation Abdominal aortic aneurysm One-time screening for men ages 65 - 75 years who have smoked Alcohol misuse screening and counseling Interventions to reduce alcohol misuse Aspirin prevention medication Recommends initiating low-dose aspirin use for the primary prevention of cardiovascular disease and colorectal cancer in adults aged 50 to 59 years who have a 10% or greater 10-year cardiovascular risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years Blood pressure screening For adults age 18 and older Cholesterol screening For men ages 35 and older and women 45 and older or starting at 20 if you are at increased risk for coronary heart disease Colorectal cancer screening For adults ages 50 - 75 Depression screening For all adults Diabetes screening For adults ages 40 and older who are overweight or obese Healthy diet and physical activity counseling For adults who are overweight or obese and have additional cardiovascular disease (CVD) risk factors Hepatitis B screening For adults at high risk Hepatitis C screening For adults born between 1945 - 1965 Human immunodeficiency virus (HIV) screening For adults at increased risk Lung cancer screening For adults ages 55 - 80 who have smoking history or currently smoke Nutritional therapy members with diabetes or renal disease Medicare coverage when the following are true: - Receive a referral from their treating physician
- Diagnosed with diabetes or renal disease or received a kidney transplant within the last 36 months
- Service provided by a registered dietitian or nutrition professional
Obesity screening and counseling For adults with body mass index of 30 kg/m2 or higher Prostate cancer screening For men who is at least 50 years of age with no symptoms or who is at least 40 years of age and has family history of prostate cancer Sexually transmitted infection (STI) counseling For all sexually active adolescents and adults at increased risk for STIs Statin preventative medication For adults ages 40-75 of age with no history of cardiovascular disease (CVD), 1 or more CVD risk factors, and a calculated 10-year CVD event risk of 10% or greater Tobacco use counseling and interventions For adults to provide behavioral intervention to help stop using tobacco and FDA approved cessation products Syphilis screening For adults that are at high risk Tuberculosis screening For adults at increased risk Skin cancer counseling For adults ages 10 - 24 who have fair skin and are at high risk Exercise and physical therapy For adults ages 65 and older who are at increased risk for falls Vitamin D supplements For adults age 65 and older who are at increased risk for falls Wellness visits Comprehensive evaluation and management services -
Women
Assessment, Screening and Counseling Recommendation BRCA risk assessment and genetic counseling/testing For women whose family history is associated with an increased risk for deleterious mutations in BRCA1 or BRCA2 genes Breast cancer mammography screening For women ages 35 and older. Screening includes digital breast tomosynthesis (DBT) Breast cancer preventive medication For women who are at increased risk for breast cancer and have no prior diagnosis of breast cancer Cervical cancer (Pap Smear) screening For women ages 18 - 65 years Contraceptive counseling and contraception methods FDA-approved contraceptive methods, sterilization procedures, education and counseling Domestic violence and intimate partner violence Screening and counseling Folid acid supplements For women planning or capable of pregnancy Human immune-deficiency virus (HIV) screening and counseling For all sexually active women Human papilloma virus (HPV) screening For women ages 18 - 65 years Osteoporosis screening For women ages 65 or older and in younger women whose fracture risk is equal to or greater than that of a 65-year-old women Sexually transmitted infection (STI) screening For chlamydia, gonorrhea and syphilis for sexually active women who are at high risk. Well-woman visit For women to obtain the recommended preventive services that are age and developmentally appropriate -
Pregnant Women
Assessment, Screening and Counseling Recommendation Aspirin to prevent preeclampsia Use of low-dose aspirin after 12 weeks of gestation if at high risk for preeclampsia Bacteriuria screening with urine culture Between 12 - 16 weeks gestation or during first prenatal visit if later Breast pump and supplies One electric breast pump per completed pregnancy Breastfeeding support and interventions Interventions during pregnancy and after birth to promote and support breastfeeding Depression screening For pregnant and postpartum women Diabetes screening After 24 weeks of gestation Hepatitis B screening First prenatal visit Human immunodeficiency virus (HIV) screening For all pregnant women Preeclampsia screening For pregnant women with blood pressure measurements throughout pregnancy Rh incompatibility screening First visit and follow-up for women at high risk Routine maternity care Prenatal visits and follow-up testing Syphilis screening During the pregnancy Tobacco use counseling For all pregnant women -
Children
Assessment, Screening and Counseling Recommendation Alcohol misuse Screening and counseling interventions for children 11 years and older to reduce alcohol misuse Anemia screening For children 1 year Autism screening At 18 and 24 months Bilirubin screening For newborn 0 - 30 days Blood pressure screening Starting at age 3 years Critical congenital heart disease screening For newborn after 24 hours of age, before discharge from hospital Dental caries prevention Application of fluoride varnish to primary teeth for all infants and children through age 5 years Depression screening For major depressive disorder in adolescents ages 12 - 18 years Development screening For children up to age 3 years Dyslipidemia Screening For children at high risk of lipid disorders ages 1 - 17 years Gonorrhea prophylactic medication For newborn for the prevention of gonococcal ophthalmia neonatorum Height, weight and body mass index (BMI) For children 0 - 20 years Hearing loss screening For newborn and children up to age 10 years Hemoglobinopathies screening For newborn 0 - 30 days Human immune-deficiency virus (HIV) screening For adolescents at increased risk Hypothyroidism and metabolic disease screening For newborn 0 - 30 days Lead screening For children 0 - 21 years Length/Height and Weight For children 0 - 21 years Maternal depression screening For children 0 - 6 months Obesity screening and counseling For children 6 - 21 years Oral risk assessment (Dental) For children 6, 9, 12, 18, 34 months and 6 years Phenylketonuria screening For newborn 0 - 30 days Psychosocial/Behavioral assessments For infants and children Sexually transmitted infection (STI) screening and counseling For adolescents who are at high risk Tobacco, alcohol and drug use assessment For children 11+ years Tobacco use counseling For ages 6 - 18 years to prevent initiation of tobacco use in school-aged children and adolescents Tuberculosis screening For children at high risk Visual acuity screening For all children at least once between ages 3 and 5 years to detect the presence of amblyopia or its risk factors Well-child visit Comprehensive evaluation and management services
Immunizations for:
Vaccines recommended by Centers for Disease Control and Prevention (CDC). Doses, recommended ages and recommended population vary.
For recommendations and schedules, see Center for Disease Control and Prevention.
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Children Ages 0 Through 6 Years Old
Diphtheria, tetanus, & acellular pertussis (DTaP) Haemophilus influenza type b (Hib) Hepatitis A (HepA) Hepatitis B (HepB) Influenza (Flu) Measles, mumps, and rubella (MMR) Meningococcal Pneumococcal conjugate (PCV13) Polio Varicella -
Children Ages 7 Through 18 years
Hepatitis A (HepA) Hepatitis B (HepB) Human papillomavirus (HPV) Influenza (Flu) Measles, mumps, and rubella (MMR) Meningococcal Pneumococcal conjugate (PCV13) Tetanus, Diphtheria, Pertussis (Td/Tdap) Polio Varicella -
Adults 19 Years Old and Older
Haemophilus influenza type b (Hib) Hepatitis A (HepA) Hepatitis B (HepB) Herpes zoster (Shingles) Human papillomavirus (HPV) Influenza (Flu) Measles, mumps, and rubella (MMR) Meningococcal Pneumococcal conjugate (PCV13) Tetanus, Diphtheria, Pertussis (Td/Tdap) Varicella