Pre-Exposure Prophylaxis (PrEP) for Human Immunodeficiency Virus (HIV) Prevention

CMS nationally covers FDA‑approved antiretroviral PrEP for individuals at increased risk of HIV acquisition as determined by the treating clinician, including furnishing, dispensing, and injectable administration, effective for claims on or after September 30, 2024. Coverage includes up to eight counseling visits and up to eight HIV screening tests per 12 months and a single HBV screening using FDA‑approved, CLIA‑compliant tests; Medicare Part B coinsurance and deductible are waived for this preventive service.

"CMS covers PrEP using FDA‑approved antiretroviral drugs to prevent HIV in individuals at increased risk of HIV acquisition as determined by the treating physician or health care practitioner."

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