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Medicare now covers Pap smear and HPV tests for women 30 to 65

Medicare will pay for women to get a joint Pap smear and human papillomavirus test every five years to screen for cervical cancer, according to a final national coverage decision released Thursday.

“CMS has determined that the evidence is sufficient to add HPV testing once every five years as an additional preventive service benefit under the Medicare program for asymptomatic beneficiaries aged 30 to 65 years in conjunction with the Pap smear test,” the CMS said in its coverage notice.

Before the decision, Medicare covered a screening pelvic examination and Pap test for women at 12- or 24-month intervals but did not cover HPV testing. The scope of the new decision is limited to screening for cervical cancer, along with HPV testing.

The CMS proposed the policy in April and accepted comments through May 16. The 17 responses were supportive of the coverage expansion.

The agency did not reveal if it performed an analysis of what it would cost to grant coverage for the joint testing and no such data was disclosed in the coverage notice. A Pap smear generally costs about $40 per screening, and HPV tests cost between $50 and $100.

Combination Pap smear and HPV testing every five years for women ages 30 to 65 received a grade A recommendation from the U.S. Preventive Services Task Force in March 2012.

An estimated 12,900 new cases of invasive cervical cancer were expected to be diagnosed in the U.S. by the end of 2015, according to the American Cancer Society, and 4,100 women with the disease may die from it this year. Most cervical cancers occur among women who have never been screened or who have received inadequate screening.

Cervical cancer tends to occur in midlife, with most cases found in women younger than age 50, the cancer society says. But more than 15% of cervical cancer cases are diagnosed in women over 65.

The five-year joint screening strategy has been endorsed by various provider groups, including the American Academy of Family Physicians, the American Cancer Society, the American Congress of Obstetricians and Gynecologists, the American Society for Clinical Pathology and the American Society for Colposcopy and Cervical Pathology.


Virgil Dickson

Virgil Dickson reports from Washington on the federal regulatory agencies. His experience before joining Modern Healthcare in 2013 includes serving as the Washington-based correspondent for PRWeek and as an editor/reporter for FDA News. Dickson earned a bachelor's degree from DePaul University in 2007.

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