Annual Primary Care Visit Recommendations

Core Laboratory Tests

The American College of Physicians recommends complete blood count (CBC) with differential to screen for anemia, infection, and blood disorders in all adults 1
Comprehensive metabolic panel (CMP) is recommended to assess kidney function, liver function, and electrolyte balance in all adults 1
Lipid profile, including total cholesterol, LDL, HDL, and triglycerides, is recommended to assess cardiovascular risk in all adults 1, 2
Hemoglobin A1C is recommended to screen for diabetes and prediabetes in all adults 1, 3
Urinalysis with albumin-to-creatinine ratio is recommended to screen for kidney disease and urinary tract infections in all adults 1
Blood pressure measurement is recommended at every visit for all adults 2, 4

The American Diabetes Association recommends annual testing for adults with BMI ≥25 kg/m² with one or more risk factors 3, 5
Risk factors for diabetes include first-degree relative with diabetes, high-risk race/ethnicity, history of cardiovascular disease, hypertension, HDL <35 mg/dL, triglycerides >250 mg/dL, polycystic ovary syndrome, physical inactivity 3
The American Diabetes Association recommends yearly testing for patients with prediabetes (A1C 5.7-6.4%) 3
The American Diabetes Association recommends beginning testing at age 35 and repeating every 3 years if normal for all other adults 3
Annual blood pressure check is recommended for all patients 4
Fasting lipid profile is recommended every 6-12 months for all patients 4
Abdominal ultrasonography is recommended once for men aged 65-75 years who have ever smoked 4

Thyroid-stimulating hormone (TSH) testing is particularly important for women and older adults 1, 6
Bone densitometry is recommended for postmenopausal women and men age ≥50 years 4
Functional performance assessment is recommended for adults ≥65 years 2
Screening for cognitive impairment is recommended in older adults with risk factors 7
Structural brain imaging (MRI preferred, or CT if MRI is contraindicated) is recommended for older adults with cognitive or behavioral symptoms 7

Vitamin B12 levels are recommended for patients on metformin 1, 2
Serum potassium levels are recommended for patients on ACE inhibitors, ARBs, or diuretics 1, 2

Diet and nutrition guidance is recommended for all adults 8
Physical activity recommendations are recommended for all adults 8
Tobacco cessation counseling is recommended for all adults 8
Alcohol and substance use counseling is recommended for all adults 8
Depression, anxiety, and disordered eating screening is recommended for all adults 8, 2

The American Heart Association, as published in Circulation, recommends personalized health advice and referral to health education or preventive counseling services as part of the Medicare Annual Wellness Visit 9