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Preventive Services Guide
- Medicare Preventive Services Resource Guide
- Alcohol Misuse and Counseling
- Annual Wellness Visit Screening
- Bone Mass Measurements
- Cardiovascular Disease Screening Tests
- Colorectal Cancer Screening
- Counseling to Prevent Tobacco Use
- Depression Screening
- Diabetes Screening
- Diabetes Self-Management Training
- Glaucoma Screening
- Hepatitis B Virus Screening
- Hepatitis B Virus Vaccine and Administration
- Hepatitis C Virus Screening
- Human Immunodeficiency Virus Screening
- Influenza Virus Vaccine and Administration
- Initial Preventive Physical Examination
- Intensive Behavioral Therapy for Cardiovascular Disease
- Intensive Behavioral Therapy for Obesity
- Lung Cancer Screening Counseling and Annual Screening for Lung Cancer with Low-Dose Computed Tomography
- Medical Nutrition Therapy
- Pneumococcal Vaccine and Administration
- Pre-Exposure Prophylaxis Using Antiretroviral Therapy to Prevent HIV Infection
- Prolonged Preventive Services
- Prostate Cancer Screening
- Screening for Cervical Cancer with Human Papillomavirus Tests
- Screening for Sexually Transmitted Infections and HIBC to Prevent STIs
- Screening Mammography
- Screening Pap Tests
- Screening Pelvic Examinations
- Ultrasound Screening for Abdominal Aortic Aneurysm
- Vaccinations
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Related Articles
- Medicare Preventive Services Resource Guide
- Medicare’s Annual Wellness Visit in Illinois: Understanding the Benefit and Preventing Denials
- Medicare’s Annual Wellness Visit in Minnesota: Understanding the Benefit and Preventing Denials
- Medicare’s Annual Wellness Visit in Wisconsin: Understanding the Benefit and Preventing Denials
Preventive Services Guide
Diabetes Screening
Table of Contents
- Diabetes Screening
- Coverage Criteria and Frequency Limits
- HCPCS/CPT Coding
- Diagnosis Coding
- Cost Sharing
- Reimbursement
- Common Claim Denials
- Related Content
Diabetes Screening
Effective for claims with dates of service on or after 1/1/2024, frequency limitations for diabetes screening are restricted to not more often than twice within the 12-month period following the date of the most recent diabetes screening test of that individual for all eligible beneficiaries.
Medicare no longer distinguishes diabetes screening frequency limitations based on a prior diagnosis of pre-diabetes. The definition of pre-diabetes has been removed from diabetes screening regulatory text at 42 CFR 410.18.
Coverage Criteria and Frequency Limits
- Maximum of two diabetes screening tests within 12-month period
HCPCS/CPT Coding
- 82947: Glucose – quantitative, blood (except reagent strip)
- 82950: Glucose – post glucose dose (includes glucose)
- 82951: Glucose – tolerance test (GTT), three specimens (includes glucose)
- 83036: Hemoglobin; glycosylated (A1c)
Diagnosis Coding
- Z13.1
Cost Sharing
- Coinsurance waived
- Deductible waived
Reimbursement
- MPFS: Fee Schedule Lookup
Nonparticipating Providers
- Nonparticipating reduction applies
- Limiting charge provision applies
Common Claim Denials
- Beneficiary not at risk for diabetes
- Beneficiary previously diagnosed with diabetes
Related Content
- CMS IOM Publication 100-02, Medicare Benefit Policy Manual, Chapter15, Section 300
- CMS IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 18, Section 90
- MLN® Educational Tool: Medicare Preventive Services
Revised 1/30/2025