Intensive Behavioral Therapy for Cardiovascular Disease

CMS covers one annual, face-to-face intensive behavioral therapy CVD risk-reduction visit for Medicare beneficiaries who are competent and alert when delivered by a qualified primary care physician or primary care practitioner in a primary care setting. The visit must include aspirin counseling for primary prevention (men 45–79, women 55–79 when benefits outweigh risks), blood pressure screening for adults ≥18 years, and intensive diet counseling for adults with hyperlipidemia, hypertension, advancing age, or other CVD/diet-related risk factors, using the USPSTF Five As approach. Coinsurance and the Part B deductible are waived for this preventive service, and services outside the defined primary care settings or provided by non-qualified providers are not covered.

"One face-to-face CVD risk reduction visit per year is covered for Medicare beneficiaries who are competent and alert, when furnished by a qualified primary care physician or primary care practition..."