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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.

Internal Medicine Meeting Early Registration Discount

Internal Medicine Meeting Early Registration Discount

Register early for Internal Medicine Meeting 2015 in Boston, MA to lock in the lowest possible rate. Learn more or register now!

Are You Using ACP Smart Medicine®?

Are You Using ACP Smart Medicine?

This online clinical decision support tool is a FREE benefit of ACP membership delivering point-of-care access to evidence-based recommendations. Includes more than 500 modules, images and reference tables. Start now or watch the video tour.