Preventive Care Services for:

  • 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:
    1. Receive a referral from their treating physician
    2. Diagnosed with diabetes or renal disease or received a kidney transplant within the last 36 months
    3. 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.

  • 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
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