CMS posts National Coverage Determination for PrEP to prevent HIV infection

Oct. 7, 2024
NCDs are posted on the CMS Medicare Coverage Center website and provide stakeholders with the Medicare coverage criteria for each technology, a summary of the evidence considered, and CMS’ rationale for the decision.

The Centers for Medicare and Medicaid Services (CMS) posted a final National Coverage Determination (NCD) for Pre-exposure Prophylaxis (PrEP) Using Antiretroviral Drugs to Prevent Human Immunodeficiency Virus (HIV) Infection.

Under this NCD, Medicare will cover oral and injectable forms of PrEP and other related services to prevent HIV without cost-sharing (i.e., deductibles or co-pays) under Medicare Part B, expanding access to these preventive medications.

Information on Medicare coverage of PrEP for HIV prevention can be found on this fact sheet and on this consumer summary.

CMS release