Screening for Hepatitis B Virus (HBV) Infection

CMS covers HBV screening using FDA-cleared laboratory tests when ordered by a primary care physician/practitioner in a primary care setting for asymptomatic beneficiaries at defined high risk (including persons from high-prevalence regions, certain US-born unvaccinated persons with high-risk parental origin, HIV-positive persons, MSM, injection drug users, and household/sexual contacts). Pregnant women are screened at the first prenatal visit for each pregnancy and may be rescreened at delivery if new or continuing risk factors exist; annual repeat screening is allowed only for continued high-risk beneficiaries who remain unvaccinated. Screening is not covered for symptomatic persons, persons already diagnosed with HBV, or nonpregnant beneficiaries who have already received hepatitis B vaccination, and services must be provided in eligible primary care settings with appropriate documentation in the medical record.

"Screening for HBV infection with FDA-approved/cleared laboratory tests used consistent with FDA labeling and CLIA regulations is covered when ordered by the beneficiary's primary care physician/pra..."