Preventive Care Services for Adults
Preventive Care Services for Women
Preventive Care Services for Pregnant Women
Preventive Care Services for Children
Immunizations for children birth through 6 years old
Immunizations for pre-teens and teens 7 through 18 years older
Immunizations for adults 19 years and older
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:
- 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 |
Preventive Care Services for 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 |
Preventive Care Services for 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 |
Preventive Care Services for 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 children birth through 6 years old
Doses, recommended ages, and recommended population vary
| 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 |
Vaccines recommended by Centers for Disease Control and Prevention (CDC).
For recommendations and schedules see Center for Disease Control and Prevention
https://www.cdc.gov/vaccines/schedules/easy-to-read/child.html
Immunizations for pre-teens and teens 7 through 18 years older
Doses, recommended ages, and recommended population vary
| 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 |
Vaccines recommended by Centers for Disease Control and Prevention (CDC).
For recommendations and schedules see Center for Disease Control and Prevention
https://www.cdc.gov/vaccines/schedules/easy-to-read/preteen-teen.html
Immunizations for adults 19 years and older
Doses, recommended ages, and recommended population vary
| 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 |
Vaccines recommended by Centers for Disease Control and Prevention (CDC).
For recommendations and schedules see Center for Disease Control and Prevention
https://www.cdc.gov/vaccines/schedules/easy-to-read/adult.html