• 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

    Posted on Dec 11, 2014 by David Twiddy

    Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.