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.

Who Is Covered

All female Medicare beneficiaries

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 papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision

P3001 - Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician

Q0091 - Screening papanicolaou smear; obtaining, preparing and conveyance to lab

ICD-10-CM Codes

High risk

   • Z77.21, Z77.22, Z77.9, Z91.89, Z92.89, Z72.51, Z72.52, and Z72.53

Low risk

   • Z01.411, Z01.419, Z12.4, Z12.72, Z12.79, and Z12.89

Frequency

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

Every 2 years for women at normal risk

Medicare Beneficiary Pays

   • Copayment waived

   • Coinsurance waived

   • Deductible waived

References