United States Preventive Services Task Force (USPSTF) Recommended Services and Medicare Coverage for Prevention in Adults 65 Years of Age and Older
| Service | Rating | Details | Preventive Coordination: Risk Assessment, Patient Motivation, and Arranging the Service | Preventive Service: Test, Screening Instrument, or Counseling |
|---|---|---|---|---|
| Partially reproduced and reprinted with permission from: Lesser LI, Bazemore AW. Improving the delivery of preventive services to Medicare beneficiaries. JAMA. 2009;302(24):2699–2700. | ||||
| BMD = bone mineral density; Pap = Papanicolaou; WMV = Welcome to Medicare Visit. | ||||
| aFor services where the USPSTF including screening and counseling in the same recommendation, the screening portion was considered as “risk assessment and arrangement.” | ||||
| bColonoscopy would be fully covered, as, if normal, would only need one-time screen. Sigmoidoscopy and fecal occult blood testing would not be, as repeated screenings would be needed. | ||||
| Abdominal aortic aneurysm (screening) | B | One-time ultrasound for men ≥65 y who have ever smoked | Fully | Fully |
| Alcohol (screening and counseling)a | B | Screen and counsel all adults | Partial: WMV only | Fully |
| Breast cancer, genetic risk assessment (screening) | B | Referral for genetic counseling with option for testing for women with a family history suggestive of breast cancer mutation | Fully | None |
| Breast cancer, mammography | B | Screen all women, ages 50–74 y, every 2 y | Partial: WMV only | Fully |
| Cervical cancer, at increased risk | A | Screen all women who have been sexually active and have a cervix. Recommends against screening women >65 y if they have had adequate recent screening with normal Pap smears and are at otherwise not at high risk | Partial: WMV only | Fully |
| Colon cancer ages 50–75 y | A | Screen with fecal occult blood testing, sigmoidoscopy, or colonoscopy, from the ages of 50 to 75 y | Partial: WMV onlyb | Fully |
| Depression (screening) | B | Screen adults for depression, when care supports are available | Partial: WMV only | Partial: WMV only |
| Diabetes, if at risk | B | Screen adults with sustained blood pressure (either treated or untreated) >135/80 mm Hg | Partial: WMV only | Fully |
| Healthy diet, if at risk (counseling) | B | Intensive counseling (usually multiple sessions lasting 30 min or more) for adults with risks for cardiovascular or diet-related chronic disease | Partial: WMV only | Partial: inconsistent indication |
| High blood pressure | A | Check the blood pressure of all adults | Partial: WMV only Partial: inconsistent indication | Partial: WMV only |
| Lipid disorders, men >35 y | A | Screen all, with an uncertain, but likely interval of every 5 y. Repeated screening less likely of benefit in those >65 y | Partial: WMV only | Fully |
| Lipid disorders, women >45 y at increased risk | A | Screen all, with an uncertain, but likely interval of every 5 y. Repeated screening less likely of benefit in those >65 y | Partial: WMV only | Fully |
| Obesity (screening with intensive counseling)a | B | Screen all adults and offer high-intensity counseling for obese adults | Partial: WMV only | Partial: inconsistent indication |
| Osteoporosis, women at risk | B | Screen all women >65 y. Interval uncertain, but yield of repeated screening will be higher in older women, those with lower BMD at baseline, and those with other risk factors for fracture | Partial: WMV only | Fully |
| Tobacco use | A | Ask all adults about tobacco use and provide tobacco cessation interventions for those who use tobacco products | Partial: WMV only | Fully |