Back to Preventive Services Home Page

Screening Pap Tests (NCD 210.2)

Medicare covers Pap tests and screening pelvic exams to check for cervical and vaginal cancers. As part of the pelvic exam, Medicare also covers a clinical breast exam to check for breast cancer.

HCPCS/CPT Codes


G0123 – Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision

G0124 – Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician

G0141 – Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician

G0143 – Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision

G0144 – Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision

G0145 – Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision

G0147 – Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision

G0148 – Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening

P3000 – Screening Pap smear by technician under physician supervision

P3001 – Screening Pap smear requiring interpretation by physician

Q0091 – Screening Pap smear; obtaining, preparing and conveyance to lab

ICD-10-CM (ICD-9-CM) Codes


Report one of the following codes:

  • Low Risk – V72.31 (Z01.411 or Z01.419), V76.2 (Z12.4), V76.47 (Z12.72), V76.49 (Z12.89)
  • High Risk – V15.89 (Z77.9 or Z92.89)
  • High risk – Z77.21, Z77.22, Z77.9 (V15.89), Z91.89, Z92.89 (V15.89), Z72.51, Z72.52, and Z72.53
  • Low risk – Z01.411 (V72.31), Z01.419 (V72.31), Z12.4 (V76.2), Z12.72 (V76.47), Z12.79, and Z12.89 (V76.49)

Who Is Covered


All female Medicare beneficiaries

Frequency


Annually if at high risk for developing cervical or vaginal cancer or childbearing age with abnormal Pap test within past 3 years; or

Every 2 years for women at normal risk

Beneficiary Pays


You pay nothing for the Pap test. You pay nothing for the pelvic exam (including a clinical breast exam) if the doctor accepts assignment.

  • Copayment/coinsurance waived
  • Deductible waived

Frequently Asked Questions (FAQs)


Am I at high risk for cervical cancer?

Your risk of developing breast cancer increases if any of these are true:

  • You’ve had an abnormal Pap test.
  • You’ve had cervical or vaginal cancer in the past.
  • You have a history of sexually transmitted disease (including HIV infection).
  • You began having sex before age 16.
  • You’ve had 5 or more sexual partners.
  • Your mother took DES (Diethylstilbestrol), a hormonal drug, when she was pregnant with you.

Back to Preventive Services Home Page