Annual Wellness Visit to Provide Personalized Preventive Plan Benefit
Annual Wellness Visit Benefit Overview
Which procedure codes do I need to use to bill for an AWV service to a beneficiary?
CMS established Healthcare Common Procedure Coding System (HCPCS) codes that physicians are required to use to bill for AWV services. These agency-maintained HCPCS “G” codes are:
G0438 – Annual wellness visit; includes a personalized prevention plan of service, first visit
G0439 – Annual wellness visit; includes a personalized prevention plan of service, subsequent visit
CMS decided to establish these HCPCS codes after determining that no existing code adequately describes the AWV services. While CMS notes that elements included in an AWV service can overlap with elements furnished as part of an age-specific periodic comprehensive preventive medicine service as defined by CPT 99381-99397, the agency determined that it needed billing codes that explicitly describes the AWV services.
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