CMS considers coverage and payment for some HPV testing

Currently, Medicare does not cover or pay for screening for human papillomavirus (HPV).

That could change soon as the Centers for Medicare & Medicaid Services (CMS) is seeking public opinion on a proposed new covered service that would link HPV screenings with a longer interval screening for cervical cancer.

Under Part B, Medicare now covers and pays for a screening pelvic examination and Pap smear test for all female beneficiaries at 12- or 24-month intervals, based on specific risk factors. In April, the American Academy of Family Physicians (AAFP) requested a new pathway that would screen female patients ages 30-65 at five-year intervals and include HPV testing. This pathway has received a grade A from the United States Preventative Services Task Force.  

A 30-day comment period on the proposal, also known as a national coverage analysis (NCA), ends Dec. 25. Additional information on the NCA, including instructions on how to comment, is available on the CMS web site.

CMS’s proposed decision memo on the matter is due on May 25, 2015, with an expected completion date of Aug. 23, 2015. If CMS agrees to extend coverage in this area, payment will likely follow, although it is unclear how quickly the payment will follow the coverage.

– Kent Moore, Senior Strategist for Physician Payment for the American Academy of Family Physicians