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Medicare To Cover Joint Pap Test and HPV Testing

Medicare To Cover Joint Pap Test and HPV Testing

July 13, 2015 — CMS in a final coverage decision released Thursday said Medicare will now cover for women joint Pap tests and human papillomavirus testing to screen for cervical cancer every five years, Modern Healthcare reports (Dickson, Modern Healthcare, 7/9).

Background

Previously, Medicare covered a Pap test and pelvic exam every 12 or 24 months for all female beneficiaries. The program did not cover HPV testing.

In April, CMS in a proposed coverage expansion memo recommended that Medicare cover HPV testing every five years -- in conjunction with Pap tests -- for female beneficiaries ages 30 to 65. The proposal followed an analysis CMS conducted last year on expanding such coverage among Medicare's younger beneficiaries, who are eligible for Medicare because of disabilities.

The proposal aligns with guidelines released by the U.S. Preventive Services Task Force in March 2012 (Women's Health Policy Report, 4/20).

Coverage Details

CMS in the coverage notice wrote the agency "determined that the evidence is sufficient to add HPV testing once every five years as an additional preventive service benefit under the Medicare program for asymptomatic beneficiaries aged 30 to 65 years in conjunction with the Pap smear test."

CMS did not disclose whether it performed an analysis of how much the expended coverage will cost. According to Modern Healthcare, Pap tests usually cost around $40 per test, while HPV tests usually cost $50 to $100 (Dickson, Modern Healthcare, 7/9).