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Annual Wellness Visit to Provide Personalized Preventive Plan Benefit

Annual Wellness Visit Benefit Overview

Can I include elements when furnishing an AWV service beyond the elements that are listed as required?

Yes. To illustrate, a review of a beneficiary’s risk for depression and an assessment of functional ability and level of safety are only required elements for the first AWV service but a physician can continue to address these issues voluntarily in subsequent AWVs. CMS notes it would be appropriate to continue to screen for depression in subsequent AWVs for certain beneficiaries as evidence dictates that recurrent depression screening is indicated for a subgroup of patients. Continued screening for functional ability would be appropriate for those who it is determined a priority area.

Voluntary advance care planning is another element in which you may engage a beneficiary even though it is not listed as a CMS-identified component. CMS had established voluntary advance care planning as an option component when it released the final version of its 2011 rules for the AWV benefit in November 2010. The agency only eliminated reference to the advance care planning element in the first week of January 2011. The CMS rationale for withdrawing it is that the agency’s failure to mention advance care planning as an element when it proposed 2011 AWV benefit rules in July 2010, meaning that the public did not have adequate opportunity to comment on whether mention is appropriate. While advance care planning and end-of-life care issues continue to be politically continuous, ACP encourages internists to engage in advance care planning if the physician and the patient determine it is appropriate and beneficial.

The intent of the AWV benefit is to personalize prevention plan so it is prudent for physicians to exercise discretion and engage in activities beyond the required elements that are appropriate for a particular beneficiary.

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