Hepatitis C Virus (HCV)

Hepatitis C Virus (HCV) is an infection that attacks the liver and can cause major liver disease. Inflammation over long periods of time (usually decades) can cause scarring, called cirrhosis. Cirrhosis prevents the liver from performing its normal functions, which leads to liver failure. People with cirrhosis are more prone to developing cancer; liver failure leads to serious complications, even death. HCV is reported to be the leading cause of chronic hepatitis, cirrhosis, and liver cancer, and a primary indication for liver transplant in the Western World.

Medicare will cover screening for HCV for eligible beneficiaries when ordered by the beneficiary's primary care physician or practitioner within the context of a primary care setting and performed by an eligible Medicare provider for these services. 

Eligible beneficiaries who meet either of the following conditions: (1) Adults at high risk for HCV infection. "High risk" is defined as persons with a current or past history of illicit injection drug use, and persons who have a history of receiving a blood transfusion prior to 1992. (2) Adults who do not meet the high-risk definition as defined above, but who were born between 1945 through 1965. A single, once-in-a-lifetime screening test is covered for these individuals.