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Prostate Cancer Screening (NCD 210.1)

Prostate cancer may be found by testing the amount of PSA (Prostate Specific Antigen) in your blood. Another way prostate cancer may be found is when your doctor performs a digital rectal exam. Medicare covers both of these tests.

HCPCS/CPT Codes


G0102 – Digital Rectal Exam (DRE)

G0103 – Prostate Specific Antigen Test (PSA)

ICD-10-CM (ICD-9-CM) Codes


Z12.5 (V76.44)

Who Is Covered


All male Medicare beneficiaries aged 50 and older (coverage begins the day after their 50th birthday)

Frequency


Annually for covered beneficiaries

Beneficiary Pays


G0102:

  • Copayment/coinsurance applies
  • Deductible applies

G0103:

  • Copayment/coinsurance waived
  • Deductible waived

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