CMS to Cover Hepatitis C Screening: 4 Things to Know

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The Centers for Medicare and Medicaid Services will now cover hepatitis C screening. Here are four things to know about the recently released decision memo.

1. CMS concluded that HCV screening meets the U.S. Preventative Services Task Force grade B recommendations. Screening is considered reasonable and necessary for the prevention and early detection of the disease.

2. HCV screening will be covered for beneficiaries enrolled under Part A or Part B. A single screening test is covered for adults who are not defined as high risk, but who were born from 1945 through 1965.

3. The test is covered for high risk individuals. "High risk" individuals have a current or past history of illicit drug injection or have had a blood transfusion before 1992. CMS will cover annual repeat screening tests for individuals who have continued illicit drug injection after their prior negative screening.

4. CMS will cover HCV screening tests that fall in the category of FDA approved laboratory tests used with appropriate FDA approved labeling and in compliance with the Clinical Laboratory Improvement Act regulations. The test will be covered when ordered by a beneficiary's Medicare-eligible primary care physician.

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