New Service! Medicare began covering HCV screening effective June 2, 2014.

Who Is Covered

Certain adult Medicare beneficiaries who fall into at least one of the following categories:

   • Are at high risk for HCV infection; or

   • Those at high risk because they’ve had a blood transfusion before 1992

   • Were born between 1945 and 1965

HCPCS/CPT Codes

G0472 - Hepatitis C antibody screening, for individual at high risk and other covered indication(s)

ICD-10-CM Codes

Z72.89 - initial claim

F19.20 - subsequent claims for high risk beneficiaries with continued illicit injection drug use since prior negative screening

Medicare Beneficiary Pays

Medicare will only cover Hepatitis C screening tests if they’re ordered by a primary care doctor or practitioner.

You pay nothing for the screening test if the doctor or other qualified health care provider accepts assignment.

   • Copayment waived

   • Coinsurance waived

   • Deductible waived

References