Screening for the Human Immunodeficiency Virus (HIV) Infection

Medicare covers HIV screening with FDA‑approved, CLIA‑compliant tests for beneficiaries entitled to Part A or enrolled in Part B: one voluntary annual screening for all ages 15–65, one annual screening for beneficiaries <15 or >65 only if they are at increased risk, and up to three screenings during pregnancy (when pregnancy known, third trimester, and at labor). Coverage excludes beneficiaries with a known HIV diagnosis and screens are not covered if performed within the prior 1-year interval (operationalized as requiring at least 11 full months after the month of the previous test); documentation must include orders, provider information, risk assessment, prior test dates, and pregnancy status.

"Medicare covers one voluntary HIV screening annually for all beneficiaries aged 15 through 65 years, regardless of perceived risk, when ordered by the beneficiary's physician/practitioner and perfo..."