Pap Test and Pelvic Exam Detailed
Coverage: Conditions that must be met before Medicare will provide coverage, and limits to coverage.
Medicare covers Pap Tests and Pelvic Exams (and a clinical breast exam) for all women once every 24 months. If you are high risk for cervical or vaginal cancer, or if you are of childbearing age and have had an abnormal Pap Test, Medicare covers this test and exam once every 12 months. If you have your Pap Test, Pelvic Exam, and Clinical Breast Exam on the same visit as your physical exam, you pay for the physical exam. Routine physical exams are not covered by Medicare.
CoPayment: The amount you need to pay.
You pay $0 for the lab Pap Test.
You pay 20% of Medicare-approved amounts (or a copayment) for the part of the exam when the doctor or health care provider collects the specimen and for the pelvic exam.
If the pelvic exam was provided in a hospital outpatient department, you pay a set copayment amount.
Medicare Part: The part of Medicare that pays for this service or supply.
Organization Name: The organization name that this coverage topic is associated with.
Important Notes: Details regarding important notes about the coverage.
Actual amounts you must pay may be higher if a doctor, health care provider, or supplier does not accept assignment.