Initial Preventive Physical Exam

Medicare provides coverage for an Initial Preventive Physical Examination (IPPE) for HMSA’s Akamai Advantage® members within the first 12 months of their initial Medicare Part B enrollment. This is a one-time benefit.

The medical record must document the performance of the following required components:

• Review of an individual’s medical, family and social history
• Review of an individual’s potential risk factors for depression and other mood disorders based on the use of an appropriate screening instrument for persons without a current diagnosis of depression
• Review of an individual’s functional ability and level of safety based on the use of appropriate screening questions or standardized questionnaires
• An examination, including measurement of an individual’s height, weight, body mass index (or waist circumference, if appropriate), blood pressure, visual acuity screen and other routine measurements as deemed appropriate, based on the beneficiary’s medical/family history
• End-of-life planning; provide verbal or written information to the individual
• Education, counseling, and referral based on the previous five components
• Education, counseling, and referral for other preventive services and appropriate screenings, including a brief written plan for the individual to obtain these screenings/services that are covered as separate Medicare Part B benefits

For more information on IPPE, please refer to the CMS website, MLN Matters Number: MM6223.

Revision History