- Medicare Preventative Services

FAQs

Learn how to check eligibility. You may access eligibility information through the CMS HIPAA Eligibility Transaction System (HETS) either directly or through your:

Contact your eligibility services provider or find your MAC’s website.

We offer a Preventive Services Checklist so they can track their preventive services.

We may add preventive services coverage through the National Coverage Determination (NCD) process if the service is:

Reasonable and necessary for preventing or detecting illness or disability in early stages
U.S. Preventive Services Task Force (USPSTF)-recommended with grade A or B
Appropriate for people entitled to Medicare Part A benefits or enrolled under Medicare Part B

We may also add preventive services through statutory and regulatory authority.

USPSTF Published Recommendations has more preventive services information.

We define a primary care setting as a place where clinicians deliver integrated, accessible health care services and are responsible for:

Under this direction, we don’t consider these facilities as primary care settings:

Telehealth Eligible Services

Note: T beside a service title means it’s telehealth eligible.