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Annual Wellness Visit

Annual Wellness Visit Benefit Overview
Read an overview of the benefit, what is included and how to properly bill for the procedure. Learn More

How to Bill Medicare’s Annual Wellness Visit (AWV)
Diagnosis code V70.0; Initial Annual Wellness Visit G0438; Subsequent Annual Wellness Visit G0439

Medicare will pay a physician for an AWV service and a medically necessary service, e.g. a mid-level established office visit, Current Procedural Terminology (CPT) code 99213, furnished during a single beneficiary encounter. It is important that the elements of the AWV not be replicated in the medically necessary service. Physicians must append modifier -25 (significant, separately identifiable service) to the medically necessary E/M service, e.g. 99213-25, to be paid for both services.

For example, for the patient who comes in for his Annual Wellness Visit and complains of tendonitis would be billed as follows: CPT ICD9, G0438 V70.0, 99212-25 726.90 (tendonitis)

Until Medicare publishes documentation guidelines, practices should check with their local carrier for further information. Otherwise it is recommended that practices use ACP resources including the Practice Checklist, Patient Explanation Letter, and the Patient Annual Wellness Visit Report of risk factors, referrals, and screening schedule.

AMA's Medicare Preventive Services
A brochure from the AMA on preventative services provided to Medicare patients under the Affordable Care Act.

The ABCs of providing the Annual Wellness Visit
A brief summary from CMS on the minimum elements included in the Health Risk Assessment portion of Medicare's Annual Wellness Visit.

CMS article
This article is for physicians, non-physician practitioners, and providers submitting claims to Medicare contractors (carriers, Medicare Administrative Contractors (MACs), and/or Fiscal Intermediaries (FIs) for services provided to Medicare beneficiaries.

CMS Podcast
This podcast is designed to provide education on the Annual Wellness Visit (AWV) which provides personalized preventive plan services. It includes information on initial and subsequent AWVs as well as health risk management information.

ACP Tools for the Annual Wellness Visit

The following forms and templates can be customized for use in your practice:

Earn CME Credits

Earn CME Credits through attending live meetings, working online, or watching course recordings on your own schedule.

MKSAP 16 Holiday Special: Save 10%

MKSAP 16 Holiday Special:  Save 10%

Use MKSAP 16® to earn MOC points, prepare for ABIM exams and assess your clinical knowledge. For a limited time save 10% when you use priority code MKPROMO! Order now.

Maintenance of Certification:

What if I Still Don't Know Where to Start?

Maintenance of Certification: What if I Still Don't Know Where to Start?

Because the rules are complex and may apply differently depending on when you last certified, ACP has developed a MOC Navigator. This FREE tool can help you understand the impact of MOC, review requirements, guide you in selecting ways to meet the requirements, show you how to enroll, and more. Start navigating now.