Medicare Preventive Service
Components of the IPPE
ACQUIRE BENEFICIARY HISTORY and ELEMENTS
1. Review of beneficiary’s medical and social history
At a minimum, obtain the following:
Past medical/surgical history (experiences with illnesses, hospital stays, operations, allergies, injuries, and treatments);
Current medications and supplements (including calcium and vitamins);
Family history (review of medical events in the family, including diseases that may be hereditary or place the beneficiary at risk);
History of alcohol, tobacco, and illicit drug use;
Diet; and
Physical activities.
2. Review of beneficiary’s potential risk factors for depression and other mood disorders
Use any appropriate screening instrument for persons without a current diagnosis of depression recognized by national professional medical organizations to obtain current or past experiences with depression or other mood disorders.
3. Review of beneficiary’s functional ability and level
of safety
Use any appropriate screening questions or standardized questionnaires recognized by national professional medical organizations to review, at a minimum, the following areas:
Hearing impairment;
Activities of daily living;
Falls risk; and
Home safety.
BEGIN EXAMINATION
ELEMENTS
4. An examination
Obtain the following:
Height, weight, and blood pressure;
Visual acuity screen;
Measurement of body mass index; and
Other factors deemed appropriate based on the beneficiary’s medical and social history and current clinical standards.
5. End-of-life planning
End-of-life planning is a required service, upon the beneficiary’s consent. End-of-life planning is verbal or written information provided to the beneficiary regarding:
The beneficiary’s ability to prepare an advance directive in the case that an injury or illness causes the beneficiary to be unable to make health care decisions; and
Whether or not the physician is willing to follow the beneficiary’s wishes as expressed in the advance directive.
COUNSEL BENEFICIARY
ELEMENTS
6. Education, counseling, and referral based on the previous five components
Based on the results of the review and evaluation services provided in the previous five components, provide education, counseling, and referral as appropriate.
7. Education, counseling, and referral for other
preventive services
Complete a brief written plan, such as a checklist, to be given to the beneficiary for obtaining a screening electrocardiogram (EKG), as appropriate, and the appropriate screenings and other preventive services that are covered as separate Medicare Part B benefits. (See below for a list of Medicare-covered
preventive services.)
