Medicare Claims Processing Manual (Pub. 100-04), Ch. 19 § 80.5
A/B MAC (B) - Screening and Preventive Services
80.5 - A/B MAC (B) - Screening and Preventive Services
(Rev. 2075, Issued: 10-28-10, Effective: 01-01-10, Implementation: 01-28-11)
Medicare Part B makes payment for the following screening and preventive services:
• Pelvic exam;
• Glaucoma screening;
• Bone mass measurements;
• Prostate cancer screening;
• Colorectal cancer screening;
• Screening pap smear;
• Screening mammography;
• Cardiovascular screening blood tests;
• Diabetes screening tests;
• DSMT;
• Influenza virus vaccine and its administration, pneumococcal vaccine and its
administration; hepatitis b virus and its administration;
• Initial physician physical exam (IPPE) - Welcome to Medicare;
• MNT; and
• Smoking and tobacco-use cessation (counseling/screening).
Payment is made for the screening and preventive services listed, excluding vaccines,
based on the MPFS. Chapter 18 of Pub. 100-04, Medicare Claims Processing Manual
contains more information on the payment of screening and preventive services,
including the method of payment for vaccines.
Effective January 1, 2005, payment is made by the A/B MAC (B) for the services of IHS
physicians and practitioners furnished in hospitals and ambulatory care clinics for
screening and preventive services covered under §630 MMA, indefinitely extended by
§2902 of the ACA.