Medicare Initial Preventive Physical Examination (IPPE) Benefit

Includes Hearing and Balance Screening

All new Medicare beneficiaries are entitled to an initial preventive physical examination, also referred to as the "Welcome to Medicare Exam," within 12 months of enrollment in Medicare Part B program. The exam requires a review of hearing impairment, falls risk, and activities of daily living. This new preventive physical examination requirement provides an excellent opportunity for audiologists to serve as a resource to primary care physicians, as CMS has stated that abnormal screenings may warrant follow-up services such as counseling and referral. Further information on the Initial Preventive Physical Examination can be found on the CMS Welcome to Medicare Provider Resources website.

In response to comments submitted from ASHA in October, CMS provided guidance regarding appropriate standardized patient questionnaires to be used by primary care physicians (PCPs). CMS also accepted ASHA's position that primary care physicians role should be limited to questioning their patients to help flag those who require additional evaluation or are at risk. ASHA has also requested that Practicing Physicians Advisory Council (PPAC) recommend to CMS that after the initial screening, those patients in need of formal audiometric evaluation should be referred to an audiologist.

For additional information, please contact reimbursement@asha.org.