Reimbursing Physicals

February 1, 2004

How often will Medicare pay for a routine physical?

Question: How often will Medicare pay for a routine physical?

Answer: Medicare considers a "routine physical" one of its covered preventive services, but will only pay for these services every one to 10 years, depending on the service. Medicare grants an exception for more services if the patient is high-risk. Since there is a plethora of services, it's best for you to verify when Medicare will pay for each one you offer.

Go to www.medicare.gov/Publications/Pubs/pdf/prevent.pdf for Medicare's brochure regarding coverage. It will give you all the specifics. It's also nice to have on hand at the front office or nursing station if your Medicare patients are not clear on their own coverage regarding these benefits.