{"data":{"id":"us-dc/d.c.-code-31-2902","jurisdiction":"us-dc","citation":"D.C. Code § 31-2902","heading":"Payable benefits.","body":"(a)\nAny individual or group health benefit plan, including Medicaid, shall provide health insurance benefits to cover:\n(1)\nA baseline mammogram for women, including a 3-D mammogram;\n(2)\nAn annual screening mammogram for women, including a 3-D mammogram; and\n(3)\nAdjuvant breast cancer screening, including magnetic resonance imaging, ultrasound screening, or molecular breast imaging of the breast, if:\n(A)\nA mammogram demonstrates a Class C or Class D breast density classification; or\n(B)\nA woman is believed to be at an increased risk for cancer due to family history or prior personal history of breast cancer, positive genetic testing, or other indications of an increased risk for cancer as determined by a woman's physician or advanced practice registered nurse.\n\n(b)\nAny individual or group health benefit plan, including Medicaid, shall provide health insurance benefits to cover:\n(1)\nAnnual cervical cytologic screening for women; and\n(2)\nCervical cytologic screening for women upon certification by an attending physician that the test is medically necessary.\n\n(c)\nBenefits provided in accordance with this section shall not be subject to an annual or coinsurance deductible.\n\n(d)\nBenefits provided in accordance with this section shall not be subject to a co-payment except when an enrollee or subscriber elects to have a baseline mammogram, annual screening mammogram, annual cervical cytologic screening, and a cervical cytologic screening certified by an attending physician as being necessary, performed by an out-of-network provider in a preferred provider plan.\n\n(e)\nCo-payments and coinsurance may be applicable to the enrollee’s or subscriber’s office visit.\n\n(f)\nSubsections (d) and (e) of this section shall apply:\n(1)\nTo any insurance policy or subscriber contract delivered or issued for delivery in the District more than 120 days after April 5, 2005; and\n(2)\nTo any insurance policy or subscriber contract renewed, amended, or reissued 120 days after April 5, 2005.\n\n(g)\nFor the purposes of this section, the term \"breast density classification\" means the 4 levels of breast density identified in the Breast Imaging Reporting and Data System established by the American College of Radiology, which are:\n(1)\nClass A, indicating fatty breast tissue;\n(2)\nClass B, indicating scattered fibroglandular breast tissue;\n(3)\nClass C, indicating heterogeneously dense breast tissue with fibrous and glandular tissue that are evenly distributed throughout the breast; and\n(4)\nClass D, indicating extremely dense breast tissue.","path":["Title 31. Insurance and Securities.","Chapter 29. Cancer Prevention.","Subchapter I. Screening for Women."],"source_url":"https://code.dccouncil.gov/us/dc/council/code/sections/31-2902","current_through":"2026-08-20 (D.C. Law 26-175)","vintage":"","retrieved_at":"2026-08-29T05:44:07Z","sha256":"027c44af7a3a60c3004bb1fabdbb01561bbe933bbd352ca741013a98b556f20c","source_id":"us-dc","stale":false,"prev":"us-dc/d.c.-code-31-2901","next":"us-dc/d.c.-code-31-2903"},"notice":"GroundRules: Original legal text. Not legal advice."}