Identify care gaps, increase revenue, and prepare your practice for value-based care with Medicare's Annual Wellness Visits.
The Annual Wellness Visit (AWV) allows practices to gain information about the patient, including medical and family history, health risks, and specific vitals. Not to be confused with a complete physical examination, the purpose of the AWV is to review the patient’s wellness and develop a personalized prevention plan. The services provided during the AWV are different from a typical preventive care visit and expand to include emotional and psychological well-being, in addition to the patient’s physical well-being. The AWV provides an opportunity for physicians to improve the quality of care, assist in patient engagement, and optimize payment opportunities.
The CPT codes for Annual Wellness Visits are G0438 for the initial visit and G0439 for subsequent visits. These codes are used to bill Medicare for comprehensive wellness assessments and personalized prevention plans.
It is important to remember that code G0438 is for the first AWV only. The submission of G0438 for a beneficiary for which a claim code of G0438 has already been paid will result in a denial. This benefit is covered at 100% for the beneficiary.
Requirements and components for G0438 (initial visit) include:
Requirements and provisions for G0439 (subsequent visit) include:
Health Care Professionals Who May Furnish and Bill AWV:
Non-physicians must legally be authorized and qualified to provide AWVs in the state in which the services are furnished.
Better patient care starts with preventive wellness visits. Download the AAFP’s patient flier and use it to talk with your Medicare patients about the importance of scheduling a free, personalized prevention visit with you.
After viewing this webcast, you should be able to:
Estimated time required to complete the full webcast: 60 minutes
Original release date of webcast: April 4, 2017
Disclaimer
The material presented here is being made available by the American Academy of Family Physicians for educational purposes only. Please note that medical information is constantly changing; the information contained in this activity was accurate at the time of publication. This material is not intended to represent the only, nor necessarily best, methods or procedures appropriate for the medical situations discussed. Rather, it is intended to present an approach, view, statement, or opinion of the faculty, which may be helpful to others who face similar situations.
The AAFP disclaims any and all liability for injury or other damages resulting to any individual using this material and for all claims that might arise out of the use of the techniques demonstrated therein by such individuals, whether these claims shall be asserted by a physician or any other person. Physicians may care to check specific details such as drug doses and contraindications, etc., in standard sources prior to clinical application. This material might contain recommendations/guidelines developed by other organizations. Please note that although these guidelines might be included, this does not necessarily imply the endorsement by the AAFP.