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.
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.
ACP Tools for the Annual Wellness Visit
The following forms and templates can be customized for use in your practice:
Where We Stand
From the ACA to Medicare reform, ACP is advocating for internists and their patients on issues we care about.
Earn CME Credits
Earn CME Credits through attending live meetings, working online, or watching course recordings on your own schedule.
Prescribe Opioids Safely
Access this FREE online educational program to help you safely prescribe opioids and manage patients with chronic pain. Online CME is available. Find out more.
Inspire the Next Generation of Medicine
Contribute to the ACP Education Fund and support our profession and the young minds starting their careers.
Share your love of medicine by making a charitable donation today! All donations are tax-deductible.