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Centers for Medicare & Medicaid Services

*National Coverage Analysis (NCA)*

Preexposure Prophylaxis (PrEP) Using Antiretroviral Therapy to Prevent Human Immunodeficiency Virus (HIV) Infection

The Centers for Medicare & Medicaid Services (CMS) released a Technical Frequently Asked Questions for Pharmacies regarding the Preexposure Prophylaxis (PrEP) Using Antiretroviral Drugs to Prevent HIV National Coverage Determination (NCD) expected to be made public and effective in late September 2024. CMS received public feedback asking that more technical information for submitting future Medicare Part B claims for PrEP for HIV be released in advance of the final NCD. This FAQ provides more technical detail following the previous posting of the fact sheet and is available at https://www.cms.gov/files/document/faq-prep-hiv-06242024.pdf. The final NCD is expected to be similar to the proposed that was published on July 12, 2023, and pharmacies should prepare now to be ready for this transition. CMS is sharing as much information as possible before issuing the final NCD to avoid disruptions for beneficiaries. https://www.cms.gov/medicare-coverage-database/view/ncacal-tracking-sheet.aspx?ncaid=310&ncacaldoctype=all&status=all&sortBy=status&bc=17 Centers for Medicare & Medicaid Services (CMS) has sent this update. To contact Centers for Medicare & Medicaid Services (CMS) go to our *contact us [ http://www.cms.gov/About-CMS/Agency-Information/ContactCMS/index.html ] *page.

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If you have any questions about this update, please email caginquiries@cms.hhs.gov.

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