Medicare Preventive Services

Screening Pelvic Examinations (includes a clinical breast examination)

Who Is Covered

All female Medicare beneficiaries

HCPCS/CPT Codes

G0101 - Cervical or vaginal cancer screening; pelvic and clinical breast examination

ICD-10-CM Codes

High risk

   • Z77.22Z77.9Z91.89Z72.89Z72.51Z72.52, and Z72.53

Low risk

   • Z01.411Z01.419Z12.4Z12.72Z12.79, and Z12.89

Frequency

   • Annually if at high risk for developing cervical or vaginal cancer, or childbearing age with abnormal Pap test within past 3 years

   • Every 2 years for women at normal risk

Medicare Beneficiary Pays

You pay nothing for the lab Pap test. You also pay nothing for the Pap test specimen collection, pelvic exam and breast exam if the doctor accepts assignment.

   • Copayment waived

   • Coinsurance waived

   • Deductible waived

References

Screening Pap Tests and Pelvic Examinations
National Cancer Institute—cervical cancer information
CDC—cervical cancer information
U.S. Preventive Services Task Force: Cervical Cancer Screening Recommendations
American Cancer Society—Learn About Cervical Cancer
Medicare & You: women's health (video)
Medicare & You: cervical cancer (video)
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