FPM Toolbox

Medicare

Download tools to help you comply with Medicare rules for annual wellness visits and more.

Elements of the IPPE and AWV

A table outlining the requirements of the initial preventive physical exam, the initial annual wellness visit, and the subsequent annual wellness visit
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Health Risk Assessment/Medicare Wellness Checkup

A health risk assessment Medicare patients can complete as part of their annual wellness visits
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Medicare Initial Preventive Physical Examination Encounter Form ("Welcome to Medicare Physical")

An encounter form to ensure all elements of the initial preventive physical exam ("Welcome to Medicare Physical") are completed
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Medicare Opt-Out Notice

An agreement form to notify Medicare that you plan to opt out
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Medicare Preventive Physical Exam Encounter Form

An encounter form that details the components required for the "Welcome to Medicare Physical," the initial annual wellness Visit, and the subsequent annual wellness visit
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Preventive Services Covered by Medicare in 2016

A list of Medicare preventive service codes and coverage requirements
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Private Contract With Medicare Beneficiary

A contract between you and Medicare patients that they are prohibited from submitting claims to Medicare for reimbursement for services you provide
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Scheduling Resource for Medicare Wellness Visits

A resource to help schedulers communicate with Medicare patients regarding wellness visits
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Wellness Care - Letter to Patients

A sample letter to patients explaining Medicare wellness care
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