Adds a new clause (xxviii) to 42 U.S.C. 1315a(b)(2)(B) establishing promotion of voluntary, nontraumatic lower-limb major amputation prevention programs at hospitals, ambulatory surgical centers, and office-based centers (including patient risk modification and management; early screening, detection, and surveillance; testing and treatment for peripheral artery disease; and improved care coordination).

Amends section 1396d(a) to insert a new paragraph (32) adding peripheral artery disease screening tests for at-risk beneficiaries to the list of services constituting medical assistance, and adds a new subsection (kk) defining 'peripheral artery disease screening test' and 'at-risk beneficiary' and directing the Secretary to establish frequency standards. Also updates cross-references in 1396d(a) to reflect the new paragraph numbering.

Amends subsections (a)(2) and (b)(2) to add peripheral artery disease screening tests for at-risk beneficiaries to the enumerated services that are exempt from deductions, cost sharing, and similar charges under State Medicaid plans.

Amends 1396o-1(b)(3)(B) by adding a new clause (xv) to include peripheral artery disease screening tests furnished to at-risk beneficiaries among services to which alternative cost-sharing rules do not apply.

Conforming amendment changing a cross-reference in 1396a(nn)(3) from 'following paragraph (31)' to 'following paragraph (32)' to reflect the insertion of a new paragraph in 1396d(a).

Adds coverage for peripheral artery disease screening tests and adds definitions and standards for such tests and for 'at-risk beneficiary'; inserts peripheral artery disease screening tests into the initial preventive physical examination provisions.

Modifies Part B payment rules to provide that peripheral artery disease screening tests for at‑risk beneficiaries are paid at 100 percent of the lesser of actual charge or the applicable payment basis, treats outpatient department furnishing of such tests under that payment rule, amends deductible treatment for such tests, and makes conforming changes to the hospital outpatient prospective payment system exclusion text.

Conforming amendment to add a cross‑reference to the new preventive services subparagraph added for peripheral artery disease screening tests.

Adds a new exclusion specifying that Medicare payment is not made for peripheral artery disease screening tests furnished to at‑risk beneficiaries when the tests are performed more frequently than is covered under the newly added section 1861(nnn).

Redesignates paragraph and subparagraph structure in section 1834(n) and adds an inapplicability provision stating the Secretary’s authority to modify or eliminate coverage of certain preventive services does not apply to the newly added peripheral artery disease screening tests provision.