Annual Wellness Visit to Provide Personalized Preventive Plan Benefit
Annual Wellness Visit Benefit Overview
How does coverage of this service relate to coverage of the “Welcome to Medicare” visit service?
Medicare covers a one-time Initial Preventive Physical Examination/Welcome to Medicare visit that is furnished to a beneficiary within the first 12 months of his or her Part B enrollment. While the Welcome to Medicare visit service has a specific definition that includes required elements, including a comprehensive physical examination indicated by the patient’s characteristics, that are not inherent to an AWV service, it has elements in common with the AWV, including emphasis counseling, and provision of/referral for other Medicare-covered preventive services. Accordingly, the ACA prohibits Medicare coverage of an AWV service within 12 months of a beneficiary’s receipt of the Welcome to Medicare visit service.
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