Review the latest rules for HIV PrEP, hepatitis vaccine, CRC screens

Why This Topic Matters

Preventive-service coverage rules change frequently, and Medicare claim denials can occur when billing workflows lag behind CMS updates or MAC implementation schedules. Staying current helps practices reduce avoidable denials, identify appeal opportunities, and support compliant preventive screening and vaccination claims.

Article Sections

1. Check for diagnosis-driven PrEP denials

   This section covers a CMS update affecting preventive-service coverage for HIV PrEP and discusses timing, implementation, and claim review considerations. It also notes that other parts of the policy were unchanged.

2. Prepare for boosted hepatitis B vaccine coverage

   This section summarizes updated Medicare coverage guidance for hepatitis B vaccination, including eligible patient categories and administration policy changes. It also addresses effective dates and MAC implementation timing.

3. Review new CRC screening services

   This section reviews newly covered colorectal cancer screening services and related timing considerations for Medicare claims. It also addresses implementation timing and older screening services no longer covered.