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Service
Who is covered
Frequency
Intensive Behavioral
Therapy (IBT) for
Cardiovascular Disease
All Medicare beneficiaries:
■
Who are competent and alert at the time counseling is
provided; and whose counseling is furnished by a qualified
primary care physician or other primary care practitioner and
in a primary care setting
Annually for covered beneficiaries.
Screening and Behavioral
Counseling Interventions
in Primary Care to Reduce
Alcohol Misuse
All Medicare beneficiaries are eligible for alcohol screening.
Medicare beneficiaries who misuse alcohol, but whose levels
or patterns of alcohol consumption do not meet criteria for
alcohol dependence, are eligible for counseling if they are
competent and alert at the time that counseling is provided
and counseling is furnished by qualified primary care
physicians or other primary care practitioners in a primary care
setting.
■
Annually for individuals who have annual alcohol
misuse screening
■
Brief face-to-face behavioral counseling for
alcohol misuse four times per year.
Sexually Transmitted
Infections (STIs) Screening
and High Intensity
Behavioral Counseling
(HIBC) to Prevent STIs
Certain Medicare beneficiaries who are:
■
Sexually active adolescents and adults at increased risk for
STIs: and
■
Referred for this service by a primary care practitioner and
provided by a Medicare eligible primary care practitioner in a
primary care setting
■
One annual occurrence of screening for
chlamydia, gonorrhea, and syphilis in women at
increased risk who are not pregnant
■
One annual occurrence of screening for syphilis
in men at increased risk
■
Up to two occurrences per pregnancy of
screening for chlamydia and gonorrhea in
pregnant women who are at increased risk for
STIs and continued increased risk for the second
screening
■
One occurrence per pregnancy of screening for
syphilis in pregnant women; up to two additional
occurrences per pregnancy if at continued
increased risk for STIs
■
One occurrence per pregnancy of screening for
hepatitis B in pregnant women; one additional
occurrence per pregnancy if at continued
increased risk for STIs
■
Up to two HIBC counseling sessions annually
Intensive Behavioral
Therapy (IBT) for Obesity
Medicare beneficiaries with obesity (BMI ≥ 30 kg/m2) who are
competent and alert at the time that counseling is provided
and whose counseling is furnished by a qualified primary care
physician or other primary care practitioner in a primary care
setting.
■
One visit every week for the first month;
■
One visit every other week for months 2–6; and
■
One visit every month for months 7–12
At the 6-month visit, a reassessment of obesity
and a determination of the amount of weight loss
must be performed.
To be eligible for additional face-to-face visits
occurring once a month for an additional
6 months, beneficiaries must have lost at least
3kg.
For beneficiaries who do not achieve a weight
loss of at least 3kg during the first 6 months, a
reassessment of their readiness to change and
BMI is appropriate after an additional 6-month
period.
There are angels among us
Congratulations to Leslie Price,
RN, Kaseman Day Surgery Charge
Nurse, who was recognized as a
Guardian Angel by donor Mary
Ann Weems for the extraordinary
care she provided for her daughter
Elizabeth. Mary Ann is grateful for
the incredible team at Kaseman
Day Surgery but in particular,
wanted to recognize
Leslie who had an
“extremely there”
attitude. Mary Ann
was impressed with
her attentiveness, her
patience in answering
their “endless questions,” and the
way Leslie continued to check on
Elizabeth to make sure
she was okay.
Mary Ann recognized
Leslie with a donation
through Presbyterian
Healthcare Foundation’s
Guardian Angel
Program. Her gift will
continue to support the work
of the Foundation by providing
resources like patient support,
education, and equipment so that
Presbyterian can be there when
families need us most.
Do you have a Guardian Angel that
you’d like to recognize? Visit
www
.phs.org/GuardianAngelor call
505-724-6580
.