Annual Wellness Visit Overview:

Better patient care starts with preventive wellness visits. Medicare covers an Annual Wellness Visit (AWV) at no cost to patients 12 months after their initial enrollment, provided that they have not received either an initial preventive physical examination (IPPE) or annual wellness visit within the previous 12 months. 

Despite there being no cost or copay for the service, it is estimated that only 12% of eligible Medicare patients receive AWV services.

The Annual Wellness Visit (AWV) enables practices to gain information about the patient, including medical and family history, health risks, and specific vitals. The purpose of the AWV is to review this information and develop a personalized prevention plan to optimize wellness.

The services provided during the AWV are different from a preventive care visit and include not only the patient's physical well-being, but also their emotional and psychological well-being.

The AWV provides an opportunity for physicians to improve the quality of care, assist in patient engagement, and optimize payment opportunities.

By providing AWV services, you can identify care gaps and preventive services, increase revenue and prepare your organization for value-based care. 

The Opportunity:

CPT codes G0438 and G0439 pay providers to help patients identify health risks, provide preventive care recommendations and engage the patient in managing their health.

Initial AWV Billing Code

CPT Code G0438

Billing for Initial Annual Wellness Visits occurs when the patient has been enrolled in Medicare Part B coverage for 12 months and has not received either an IPPE or AWV within the previous 12 months. Requirements to bill for this code are described below:

• Formation of personalized prevention plan with intended follow up for subsequent visits
• Must be performed by a: physician (doctor of medicine or osteopathy), qualified non-physician practitioner (physician assistant (PA), nurse practitioner (NP, or certified clinical nurse specialty (CCNS), medical professional (health educator, registered dietician, nutrition professional, or other licensed practitioner), or a team of medical professionals supervised directly by a physician

Subsequent AWV Billing Code:

CPT Code G0439

Billing for Subsequent Annual Wellness Visits occurs after the 12 month period following the initial visit. The requirements to bill for this code are described below:

• Billing may occur on the same calendar month as initial AWV
• Update of original personalized prevention plan with intended follow up for subsequent visits
• Must be performed by: a physician (doctor of medicine or osteopathy), qualified non-physician practitioner (physician assistant (PA), nurse practitioner (NP), or certified clinical nurse specialty (CCNS), medical professional (health educator, registered dietician, nutrition professional, or other licensed practitioner), or a team of medical professionals supervised directly by a physician

Getting started:

AviTracks-AWV is designed to help you quickly implement AWV services with your existing staff and minimal impact to your operations. 

• Automate the data gathering for the health risk assessment
• Implement a Personalized Prevention Plan
• No large upfront costs - just an extremely affordable monthly subscription
• Subscription is based on the number of patients, so you can start small and grow

See for yourself how easy it is to implement AviTracks-AWV Annual Wellness Visit Software - request a demo today!