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Preventative Care and Immunizations

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

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 Ages 0 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.

Immunizations for Children Ages 7 Through 18 years

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

Immunizations for Adults 19 Years Old 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.

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