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Preventive Care Guide

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This guide describes federal preventive-care benefits available under Ambetter Health plans, including USPSTF A/B services, ACIP immunizations, HRSA-supported services, Bright Futures recommendations, tobacco cessation, wellness examinations, and integral services. Covered preventive care is generally provided at no cost share when performed by an in-network provider, while diagnostic services may be processed under the applicable medical benefit with member cost sharing.

Policy Summary

PayerAmbetter Nevada

PolicyPreventive Care Guide

Policy CodePolicy N/A

Change TypeNo material change

Effective DateJanuary 1, 2026

Next Review DateN/A

Key ActionDocument the preventive screening purpose, applicable population or recommendation, relevant prior screening results and intervals, and absence of symptoms or abnormal findings when applicable.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

100%In-network preventive care coverage

USPSTF A/BFederal preventive services

45-75 yearsColorectal screening age range

50-80 yearsLung cancer screening age range

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CurrentAmbetter NevadaPolicy N/A

Preventive Care Guide

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Policy Summary

PayerAmbetter Nevada

PolicyPreventive Care Guide

Policy CodePolicy N/A

Change TypeNo material change

Effective DateJanuary 1, 2026

Next Review DateN/A

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

100%In-network preventive care coverage

USPSTF A/BFederal preventive services

45-75 yearsColorectal screening age range

50-80 yearsLung cancer screening age range

65-75 yearsOne-time aneurysm screening age range

Preventive Care Coverage Criteria

Federal preventive-care eligibility

Covered when the applicable federal preventive-care recommendation or guideline is in effect.

Applicable federal source: The service is an evidence-based item or service with an in-effect USPSTF grade A or B rating; a routine-use immunization with an in-effect ACIP recommendation; evidence-informed preventive care or screening for infants, children, or adolescents supported by HRSA and Bright Futures; or women's preventive care or screening supported by HRSA.USPSTF A/B, ACIP, HRSA, or Bright Futures recommendation

Coverage becomes effective on a plan start or anniversary date one year after a new recommendation or guideline is issued.

Additional preventive benefits

Covered in addition to designated federal preventive-care recommendations when applicable.

Additional preventive benefit: The service is tobacco-cessation treatment, a wellness examination for a child or adult, or integral to furnishing a specific preventive-care benefit, such as anesthesia during sterilization surgery for women.Applicable preventive service

Additional preventive-care benefits required by state law are also covered.

No-cost-share preventive coverage

Preventive services receive no member cost share when all of the following conditions are met.

Preventive benefit processing: The service is provided by an in-network Ambetter Health provider, performed for preventive screening or prevention, appropriately reported by the provider, and provided to a member within the applicable recommendation or guideline population and interval.100% of the contracted amount; no deductible, coinsurance, or copayment

If two recommendations address the same benefit differently, the richest benefit applies.

Preventive versus diagnostic classification

A covered service is preventive when its purpose and timing meet the preventive-screening framework.

Preventive classification: The member has not previously had the screening and has no symptoms or abnormal findings suggesting an abnormality; the screening occurred within the recommended interval and findings were normal; or prior diagnostic results were normal and the physician recommends future preventive screening at preventive intervals.Recommended preventive interval

The service must be appropriately reported as preventive.

Diagnostic services excluded from preventive benefit

A service is diagnostic rather than preventive when any of the following applies.

Diagnostic classification: A prior preventive or diagnostic study was abnormal and requires further evaluation; an abnormal finding requires repeat testing sooner than the preventive interval; the member has symptoms requiring diagnosis; or the member is outside the population addressed by the applicable recommendation or guideline.Applicable non-preventive medical benefit

Deductible, coinsurance, or copayment may apply under the member's plan.

Reasonable medical management

The plan may apply reasonable medical management when a recommendation or guideline does not specify all operational details.

Coverage limitation management: The recommendation or guideline does not specify the frequency, method, treatment, or setting of the preventive service.Precertification, concurrent review, claim review, or similar practice may be used

These techniques may determine the frequency, method, treatment, or setting of the service.

Adult preventive screening and intervention recommendations

Provide the following preventive screening and interventions for the applicable adult or risk-based populations.

Hypertension screening: Screen adults with office blood-pressure measurement and obtain out-of-office measurements for diagnostic confirmation before starting treatment.Age 18 years or older

Ensure accurate diagnosis, effective treatment, and appropriate follow-up.

Intimate partner violence screening: Screen women of reproductive age, including pregnant and postpartum women, for intimate partner violence.Women of reproductive age

Lung cancer screening: Provide annual low-dose computed tomography screening to eligible adults.Age 50-80 years; at least 20 pack-years; currently smoking or quit within the past 15 years

Women's preventive services

Provide the following recommended preventive services for women.

Breast cancer screening: For women at average risk, initiate mammography no earlier than age 40 and no later than age 50, perform screening at least biennially and as frequently as annually, and continue through at least age 74.Average-risk women; initiation age 40-50; continue through at least age 74

Age alone should not be the basis for discontinuing screening. Additional imaging or pathology evaluation may be used when indicated.

Breastfeeding services and supplies: Provide comprehensive lactation support during antenatal, perinatal, and postpartum periods, including consultation, counseling, education, peer support, breastfeeding equipment, and supplies.Antenatal, perinatal, and postpartum periods

Access to a double electric pump should not be predicated on prior failure of a manual pump.

Contraception: Provide access to the full range of FDA-approved, granted, or cleared contraceptives and contraceptive care, including screening, education, counseling, provision, follow-up, management, evaluation, changes, removal, continuation, and discontinuation.

Women's screening, pregnancy, and wellness criteria

Provide the following screening and preventive care according to age, pregnancy, postpartum status, and risk.

Cervical cancer screening: Screen average-risk women aged 21-29 with cervical cytology every 3 years. For women aged 30-65, use cytology plus HPV testing every 5 years or cytology alone every 3 years. Cotesting is not recommended for women younger than 30.Age 21-29: cytology every 3 years; age 30-65: cotesting every 5 years or cytology every 3 years

Diabetes after pregnancy: Screen women with prior gestational diabetes who are not pregnant and do not have diagnosed type 2 diabetes. Test ideally within 1 year postpartum, as early as 4-6 weeks postpartum. If not screened in the first year or if the initial result is negative, screen at least every 3 years for at least 10 years after pregnancy.Prior GDM; not currently pregnant; no established type 2 diabetes

If early postpartum testing is positive, repeat at least 6 months postpartum to confirm. Repeat testing is also indicated when HbA1c was used during the first 6 months postpartum.

Diabetes in pregnancy:

Pediatric and adolescent screening criteria

Provide Bright Futures preventive services for children and adolescents according to the following schedules and risk assessments.

Anemia screening: Provide anemia screening in children up to age 22.Through age 21

Depression screening: Screen for depression at each recommended visit between ages 12 and 21. Integrate maternal postpartum depression screening into well-child visits at 1, 2, 4, and 6 months.Youth age 12-21; maternal screening at infant visits 1, 2, 4, and 6 months

Dyslipidemia screening: Perform risk assessment at ages 24 months, 4, 6, 8, 12, 13, 14, 15, and 16 years. Perform laboratory screening once between ages 9-11 and once between ages 17-21, and when a positive risk assessment indicates it.Risk assessment at specified ages; laboratory screening ages 9-11 and 17-21 or when risk assessment is positive

Childhood and infant immunization criteria

Provide routine childhood and infant immunizations according to the applicable ACIP schedule.

Varicella: Administer two doses: first at 12-15 months and second at 4-6 years. Older children and adolescents without prior vaccination or disease should also receive two doses.Dose 1: 12-15 months; dose 2: 4-6 years

Chikungunya vaccine in children: For persons aged 12 years and older traveling to an outbreak area, use the virus-like particle vaccine; it may also be considered for extended travel or residence in an area without an outbreak but with elevated risk.Age 12 years or older; travel or residence risk

DTaP and Tdap: Administer five DTaP doses and a Tdap booster at 2 months, 4 months, 6 months, 15-18 months, 4-6 years, and 11-12 years for the booster.2, 4, 6, 15-18 months; 4-6 years; Tdap at 11-12 years

Adult immunization criteria

Provide routine adult immunizations according to the applicable ACIP recommendations.

Adult varicella: Adults without evidence of immunity to chickenpox, including those without prior disease or vaccination, should receive two doses approximately one month apart.Adults without evidence of immunity

Adult chikungunya vaccine: For adults aged 18 years and older traveling to an outbreak area, use the live attenuated vaccine; it may also be considered for extended travel or residence in an area without an outbreak but with elevated risk. A virus-like particle vaccine is recommended for laboratory workers with potential exposure.Age 18 years or older; travel, residence, or occupational exposure risk

Adult Tdap/Td: Adults who have never received Tdap should receive one dose at any time, regardless of when they last received Td, followed by either Td or Tdap.Adults with no prior Tdap

Services performed for diagnostic purposes rather than preventive screening are not processed under the preventive-care benefit. This includes services for evaluating symptoms, investigating abnormal findings from prior preventive or diagnostic studies, or repeating a study at an interval shorter than the recommended preventive interval. Such services may be processed under the applicable non-preventive medical benefit and may be subject to deductible, coinsurance, or copayment.

A service performed for a member who does not fall within the applicable population addressed by the preventive recommendation or guideline is not considered preventive care. The service may therefore be processed under the applicable non-preventive medical benefit rather than the preventive-care benefit.

Screening and Immunization Schedules

Abdominal aortic aneurysm screening

PopulationMen aged 65-75 years who have ever smoked

TestUltrasonography

FrequencyOne-time screening

Cervical cytology screening

PopulationWomen aged 21-29 years

TestCervical cytology alone (Pap test)

IntervalEvery 3 years

Provider Documentation and Billing Actions

Note

Reasonable Medical Management May Apply

Reasonable medical management techniques may be used to determine coverage limitations when a recommendation or guideline does not specify the frequency, method, treatment, or setting for a recommended preventive service. These practices may include precertification, concurrent review, claim review, or similar plan processes.

Apply established medical-management practices to determine the applicable frequency, method, treatment, or setting.

Documentation Required

Support Preventive-Service Classification

Report the service as preventive only when it is performed for preventive screening and the documentation supports the applicable recommendation, population, prior results, and recommended interval.

Document that the patient falls within the applicable population for the recommendation or guideline.
Document the preventive purpose and the relevant recommendation or guideline.

Preventive Care Overview

Preventive care promotes health through early detection and prevention of disease and injury, rather than treatment of an established condition. The guide includes evidence-based recommendations from the USPSTF, ACIP, HRSA, and Bright Futures for screenings, immunizations, wellness services, and related preventive care. When a service is performed for preventive screening, appropriately reported, and provided in network, it is generally covered without member cost sharing; diagnostic follow-up is handled under the applicable non-preventive medical benefit.

Definitions and Recommendation Standards

USPSTF A/B recommendations

MeaningEvidence-based preventive items or services with an in-effect rating of A or B

Issuing bodyUnited States Preventive Services Task Force (USPSTF)

Coverage timingCoverage becomes effective on a plan start or anniversary date one year after a new recommendation or guideline is issued

ACIP recommendations

MeaningRoutine-use immunizations with an in-effect recommendation

PopulationChildren, adolescents, and adults

Issuing body

Policy Summary

PayerAmbetter Nevada

PolicyPreventive Care Guide

Policy CodePolicy N/A

Change TypeNo material change

Effective DateJanuary 1, 2026

Next Review DateN/A

SourceLink

On This Page

Discontinue after 15 years since quitting or when a health problem substantially limits life expectancy or the ability or willingness to undergo curative lung surgery.

Prediabetes and type 2 diabetes screening: Screen adults who are overweight or obese for prediabetes and type 2 diabetes and offer or refer those with prediabetes to effective preventive interventions.Age 35-70 years and overweight or obese

Visual impairment screening: Screen children at least once to detect amblyopia or its risk factors.Age 3-5 years

Syphilis screening: Screen early and universally during pregnancy, or at the first available opportunity if not screened early; screen asymptomatic nonpregnant adolescents and adults at increased risk.Pregnancy or increased infection risk

Unhealthy drug-use screening: Screen adults by asking questions about unhealthy drug use when accurate diagnosis, effective treatment, and appropriate care can be offered or referred.Age 18 years or older

Screening means asking questions rather than testing biological specimens.

Behavioral weight-loss intervention: Offer or refer adults with obesity to intensive multicomponent behavioral interventions.BMI 30 or greater

Adolescent and adult women

Includes sterilization surgery, implants, IUDs, injectables, oral contraceptives, patches, rings, diaphragms, sponges, cervical caps, condoms, spermicides, emergency contraception, and fertility-awareness instruction when desired.

STI counseling: Provide directed behavioral counseling to sexually active adolescent and adult women at increased risk for sexually transmitted infections and review sexual history and risk factors.Sexually active adolescent and adult women; enhanced focus when increased risk is present

Obesity prevention in midlife women: Counsel women with normal or overweight BMI to maintain weight or limit weight gain, including individualized discussion of healthy eating and physical activity.Age 40-60 years; BMI 18.5-29.9 kg/m2

Patient navigation for breast and cervical cancer: Provide individualized patient navigation for screening and follow-up, including assessment and planning, health-system navigation, referrals, language translation, transportation, social services, and patient education.Women undergoing breast or cervical cancer screening or follow-up

Navigation may be in-person, virtual, or hybrid.

Intimate partner and domestic violence: Screen adolescent and adult women at least annually and, when needed, provide or refer for counseling, education, harm-reduction strategies, and supportive services.Adolescent and adult women; at least annually

Anxiety screening: Screen adolescent and adult women, including pregnant and postpartum women. Use clinical judgment to determine screening frequency because optimal intervals are unknown.Adolescent and adult women, including pregnancy and postpartum

Screen pregnant women for gestational diabetes after 24 weeks, preferably at 24-28 weeks. Screen before 24 weeks, ideally at the first prenatal visit, when risk factors for type 2 diabetes or gestational diabetes are present.

Routine screening after 24 weeks; earlier screening when risk factors are present

HIV screening: Provide HIV screening at least once during the lifetime of all adolescent and adult women aged 15 years and older. Begin risk assessment and prevention education at age 13; perform earlier, additional, or annual screening when risk is increased. Screen pregnant women at initiation of prenatal care and rescreen based on risk; use rapid testing during labor when HIV status is undocumented.Routine screening age 15 years or older; risk assessment and prevention education beginning at age 13

Urinary incontinence: Screen women annually for urinary incontinence and assess its effect on activities and quality of life. Refer for further evaluation and treatment when indicated.Women; annually

Well-woman exams: Provide at least one preventive care visit per year beginning in adolescence and continuing across the lifespan. Visits may occur as one visit or a series of visits over time.Beginning in adolescence; annually

Coordinate services according to age and risk factors, including preconception, prenatal, and interconception care.

Fluoride varnish: For children at high risk, consider fluoride varnish for caries prevention every 3-6 months.Age 6 months through 5 years

Developmental and autism screening: Perform formal developmental and autism screening up to age 3.Through age 3 years

Hearing screening: Provide hearing tests at newborn age; between 3-5 days and 2 months; at ages 4, 5, 6, 8, 10, and 17 years; once between ages 18-21; and whenever risk assessment is positive.Newborn through age 21, with risk-based testing

HIV screening in children and adolescents: Conduct HIV risk assessment at ages 11, 12, 13, and 14 years. Perform screening laboratory work once between ages 15-21 and at ages 11-14 when risk assessment is positive.Risk assessment ages 11-14; laboratory screening ages 15-21 or when risk is positive

Newborn metabolic screening: Screen newborns for congenital hypothyroidism and phenylketonuria during the newborn period.Age 0-90 days

Lead screening: Provide lead screening from age 6 months until age 7 years.Age 6 months through 6 years

Psychosocial and behavioral assessment: Provide psychosocial and behavioral assessments up to age 22.Through age 21

Visual impairment screening: Provide visual acuity screening at ages 4 and 5 and for cooperative 3-year-olds. Provide instrument-based screening at 12 and 24 months and during well visits at ages 3-5 years.Instrument-based screening at 12 and 24 months; visual acuity ages 3-5 years

STI assessment and testing: Conduct STI risk assessment at each recommended visit from ages 11-21 and perform STI laboratory work when the risk assessment is positive.Risk assessment ages 11-21; laboratory testing when risk is positive

Sickle cell screening: Screen newborns for sickle cell disease.Age 0-90 days

Tobacco, alcohol, and drug-use assessment: Assess tobacco, alcohol, and drug use between ages 11 and 21.Age 11-21

Tuberculosis testing: Provide tuberculosis testing through age 22.Through age 21

Hib: Administer three or four doses depending on product: at 2 months, 4 months, 6 months for some brands, and 12-15 months.2, 4, 6 months when applicable, and 12-15 months

Hepatitis A: Administer two doses at 12-23 months and 6 months after the last dose.Dose 1: 12-23 months; dose 2: 6 months later

Hepatitis B: Administer three doses, with the second dose at 1-2 months and the third at 6-18 months.Three-dose series; dose 2 at 1-2 months; dose 3 at 6-18 months

HPV: Recommend vaccination at ages 11-12 years, with vaccination permissible beginning at age 9 in special situations. Use two doses 6-12 months apart when started at ages 11-12; use three doses over 6 months when started after the 15th birthday.Routine age 11-12; may start at age 9; three-dose series if started after age 15

A third dose is needed if two doses are given less than 5 months apart.

Inactivated poliovirus: Administer four doses at 2 months, 4 months, 6-18 months, and 4-6 years.2, 4, 6-18 months, and 4-6 years

Influenza: Administer influenza vaccine annually beginning at age 6 months; some children aged 6 months through 8 years may need two doses for best protection.Annually from age 6 months

MMR: Administer two doses at 12-15 months and 4-6 years.Dose 1: 12-15 months; dose 2: 4-6 years

Meningococcal: Administer MenB-4C Bexsero as a two-dose series at 0 and 6 months for healthy adolescents; three doses are recommended for persons aged 10 years or older at increased risk for serogroup B meningococcal disease.Healthy adolescents: 0 and 6 months; increased risk age 10 years or older: three doses

Pneumococcal: Administer four PCV13 doses at 2 months, 4 months, 6 months, and 12-15 months.2, 4, 6, and 12-15 months

Rotavirus: Use either RotaTeq RV5 at 2, 4, and 6 months or Rotarix RV1 at 2 and 4 months. Both are administered orally.RV5: three doses; RV1: two doses

RSV prevention: Infants aged 8 months or younger entering or born during their first RSV season who are not protected by maternal vaccination should receive one dose of clesrovimab.Age 8 months or younger; first RSV season; not protected by maternal vaccination

No preferential recommendation between nirsevimab and clesrovimab is stated.

Cervical cancer screening

PopulationWomen aged 30-65 years

Cytology aloneEvery 3 years

High-risk HPV testing aloneEvery 5 years

CotestingEvery 5 years

Colorectal cancer screening

PopulationAdults aged 45-49 years and all adults aged 50-75 years

HSgFOBT or FITEvery year

Stool DNA-FITEvery 1-3 years

CT colonography or flexible sigmoidoscopyEvery 5 years

ColonoscopyEvery 10 years

High BMI intervention

PopulationChildren and adolescents aged 6 years or older

BMI thresholdAt or above the 95th percentile for age and sex

InterventionComprehensive, intensive behavioral interventions, provided or referred

Lung cancer screening

Age50-80 years

Smoking history20 pack-years

Current smoking statusCurrently smokes or quit within the past 15 years

ScreeningAnnual low-dose computed tomography (LDCT)

Prediabetes and type 2 diabetes screening

PopulationAdults aged 35-70 years

Weight criterionOverweight or obese

ActionScreen for prediabetes and type 2 diabetes; offer or refer patients with prediabetes to effective preventive interventions

Vision screening

PopulationChildren aged 3-5 years

FrequencyAt least once

PurposeDetect amblyopia or its risk factors

Lung cancer screening criteria

Adult age50-80 years

Smoking exposure20 pack-year history

Smoking statusCurrently smokes or quit within the past 15 years

Method and frequencyAnnual low-dose computed tomography (LDCT)

Diabetes screening criteria

AgeAdults aged 35-70 years

Weight statusOverweight or obese

ScreeningPrediabetes and type 2 diabetes screening

Behavioral weight-loss intervention

PopulationAdults with a BMI of 30 or higher

InterventionBehavioral weight-loss interventions

DeliveryOffer or refer

Obesity prevention in midlife women

PopulationWomen aged 40-60 years

BMI range18.5-29.9 kg/m2

Counseling goalMaintain weight or limit weight gain to prevent obesity

Counseling topicsHealthy eating and physical activity

Cervical cancer screening

PopulationAverage-risk women aged 21-65 years

Ages 21-29Cervical cytology every 3 years

Ages 30-65Cytology and human papillomavirus testing every 5 years, or cytology alone every 3 years

Under age 30Cotesting is not recommended

Diabetes screening after pregnancy

PopulationWomen with prior gestational diabetes who are not pregnant and have no diagnosed type 2 diabetes

Initial testingIdeally within 1 year postpartum; may begin at 4-6 weeks postpartum

Repeat testingAt least every 3 years for a minimum of 10 years after pregnancy

Positive early postpartum resultRepeat testing at least 6 months postpartum to confirm diabetes

Gestational diabetes screening

Routine timingAfter 24 weeks of gestation, preferably between 24 and 28 weeks

Earlier screeningBefore 24 weeks, ideally at the first prenatal visit, when risk factors are present

Risk factorsRisk factors for type 2 diabetes or gestational diabetes

High-risk fluoride varnish

PopulationChildren at high risk for dental caries

Age range6 months through 5 years

FrequencyEvery 3-6 months

ServiceFluoride varnish application to prevent caries

Routine chickenpox vaccination

VaccineChickenpox (varicella)

Dose 112-15 months

Dose 24-6 years

Catch-upOlder children and adolescents without prior vaccination or disease should also receive two doses

Routine influenza vaccination

PopulationChildren

VaccineInfluenza vaccine

ScheduleEvery year, beginning at age 6 months

Additional dosingSome children aged 6 months through 8 years may need two doses for best protection

Infant RSV prevention

PopulationInfants aged 8 months or younger entering or born during their first RSV season

EligibilityNot protected by maternal vaccination

PreventionOne dose of clesrovimab

Product preferenceNo preferential recommendation between nirsevimab and clesrovimab

Document whether the screening has been performed previously and, if so, whether findings were normal.

Use the recommended preventive screening interval when prior diagnostic results were normal and the physician recommends future preventive screening.

Unsupported block type: billing_rule担

Documentation Required

Diagnostic Rather Than Preventive Indication

A service is diagnostic rather than preventive when it is performed to evaluate symptoms, abnormal prior results, or a need for repeat testing outside the recommended preventive interval. Identify the clinical reason for the service in the medical record and report it accordingly.

Record the symptom or other clinical indication requiring further diagnosis.
Record the abnormal prior preventive or diagnostic result prompting additional evaluation.
Record the circumstances requiring repeat testing sooner than the recommended preventive screening interval.
Do not classify the service as preventive solely because the same test may also be used for preventive screening.

Billing Rule

Network and Reporting Requirements

To receive preventive-care treatment, the service must be provided by an in-network Ambetter Health provider and appropriately reported as preventive. In-network preventive care is covered at 100% of the contracted amount without deductible, coinsurance, or copayment, subject to applicable plan terms and reasonable medical management.

Use an in-network Ambetter Health provider for preventive-care coverage with no cost share.
Appropriately report and bill the service as preventive when the preventive-screening criteria are met.
If the service is diagnostic, report it under the applicable non-preventive medical benefit rather than the preventive benefit.
For services tied to a specific gender recommendation, apply the recommendation by the individual's sex assigned at birth, rather than gender identity.

CDC Advisory Committee on Immunization Practices (ACIP)

Bright Futures

MeaningEvidence-informed preventive care and screening recommendations

PopulationInfants, children, and adolescents

SupportHRSA-supported guidelines established by the American Academy of Pediatrics

Preventive care

PurposePromote health and early detection or prevention of diseases and injuries

Not intended forTreating or curing diseases and injuries

ExamplesExaminations and screening tests tailored to age, health, and family history

Gender-specific recommendation

Applies toGender-specific preventive recommendations

ReferenceThe individual's sex assigned at birth

ExampleRecommendations specified for men or women

LDCT

Full termLow-dose computed tomography

UseAnnual lung cancer screening

Applicable adultsAdults aged 50-80 years with a 20 pack-year smoking history who currently smoke or quit within the past 15 years

Stop screeningAfter 15 years since quitting or when a health problem substantially limits life expectancy or ability or willingness to undergo curative lung surgery

USPSTF Rating

Grade A or BIndicates a preventive service recommended by the USPSTF

ApplicabilityThe recommendation applies to the individual's population

ExamplesLung cancer, prediabetes and diabetes, and vision screening recommendations carry USPSTF ratings

Contraceptive care

Core servicesScreening, education, counseling, and provision of contraceptives

Follow-up careManagement, evaluation, changes, removal, continuation, and discontinuation

Covered rangeFDA-approved, granted, or cleared contraceptives, effective family-planning practices, and sterilization procedures

Additional instructionFertility-awareness methods, including the lactation amenorrhea method, for women desiring an alternative method

Intimate partner and domestic violence

Forms of violencePhysical violence, sexual violence, stalking, and psychological aggression including coercion

Additional formsReproductive coercion, neglect, and threats of violence, abuse, or both

Screening populationAdolescent and adult women

FrequencyAt least annually

Well-woman exam

Visit typePreventive care visit

FrequencyAt least once per year

BeginningAdolescence

DurationContinuing across the lifespan

Patient navigation services

MethodPerson-to-person contact

Delivery modelsIn-person, virtual, or hybrid

Core activitiesIndividualized assessment and planning, health-system navigation, referrals, and patient education

Support servicesLanguage translation, transportation, and social services