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Initial Preventive Physical Examination

The Affordable Care Act provides for an initial preventive physician exam (IPPE) also known as the "Welcome to Medicare" preventative visit, for Medicare beneficiaries as of January 1, 2011. Medicare pays for one IPPE visit per lifetime that must be completed no later than 12 months after the patient’s Medicare Part B eligibility date. You should ensure your billing staff are aware of these services and how to bill for them. 

Coding and Billing an IPPE

  • G0402: Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment
  • G0403: Electrocardiogram, routine ECG with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report
  • G0404: Electrocardiogram, routine ECG with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination
  • G0405: Electrocardiogram, routine ECG with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination
  • G0468: Federally qualified health center (FQHC) visit, IPPE, or AWV, a FQHC visit that includes an initial preventive physical examination (IPPE) or annual wellness visit (AWV) and includes a typical bundle of Medicare-covered services that would be furnished per diem to a patient receiving IPPE or AWV