Clinical preventive services that receive an I or C recommendation are eligible for Medicaid coverage. States determine medical necessity criteria, and determine whether they will cover I or C recommended services. However, United States Preventive Task Force (USPSTF) grade I and C recommended services are not eligible for the one percentage point federal medical assistance percentage (FMAP) increase.
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Date
Topic
Sub Topic
FAQ ID
91661
FAQ Page
FAQ Question
Under section 4106 of the Affordable Care Act, are clinical preventive services that receive an I or C recommendation ineligible for Medicaid coverage? Are they ineligible for the increased federal financial participation (FFP)?