[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR410.17]



[Page 321]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 410_SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS--Table of Contents

 

               Subpart B_Medical and Other Health Services

 

Sec. 410.17  Cardiovascular disease screening tests.



    (a) Definition. For purposes of this subpart, the following 

definition apply:

    Cardiovascular screening blood test means:

    (1) A lipid panel consisting of a total cholesterol, HDL 

cholesterol, and triglyceride. The test is performed after a 12-hour 

fasting period.

    (2) Other blood tests, previously recommended by the U.S. Preventive 

Services Task Force (USPSTF), as determined by the Secretary through a 

national coverage determination process.

    (3) Other non-invasive tests, for indications that have a blood test 

recommended by the USPSTF, as determined by the Secretary through a 

national coverage determination process.

    (b) General conditions of coverage. Medicare Part B covers 

cardiovascular disease screening tests when ordered by the physician who 

is treating the beneficiary (see Sec. 410.32(a)) for the purpose of 

early detection of cardiovascular disease in individuals without 

apparent signs or symptoms of cardiovascular disease.

    (c) Limitation on coverage of cardiovascular screening tests. 

Payment may be made for cardiovascular screening tests performed for an 

asymptomatic individual only if the individual has not had the screening 

tests paid for by Medicare during the preceding 59 months following the 

month in which the last cardiovascular screening tests were performed.



[69 FR 66421, Nov. 15, 2004]