Get Paid with the Annual Wellness Visit

AWV Webinar: April 4th, 2017

Register for the Annual Wellness Visit webinar. Stop leaving money on the table and improve your practice’s financial health.

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Get Paid with the
Annual Wellness Visit (AWV)

What is the Medicare Annual Wellness Visit?

The Centers of Medicare & Medicaid Services (CMS) offers an opportunity for a patient to partner with their physician to focus on preventive screening and wellness. The Annual Wellness Visit (AWV) allows practices to gain information about the patient, including medical and family history, health risks, and specific vitals. Not to be confused with a complete physical examination, the purpose of the AWV is to review the patient’s wellness and develop a personalized prevention plan. The services provided during the AWV are different from a typical preventive care visit, and expand to include emotional and psychological well-being, in addition to the patient’s physical well-being.

As of January 1, 2011, CMS began paying for two CPT codes to provide this service: G0438 (initial visit) and G0439 (subsequent visit). The AWV provides an opportunity for physicians to improve the quality of care, assist in patient engagement, and optimize payment opportunities.

AWV Webinar: April 4th, 2017

Register for the Annual Wellness Visit webinar. Stop leaving money on the table and improve your practice’s financial health.

Learn more »

Questions about the Annual Wellness Visit?

Our FAQ answers your questions about the Medicare Annual Wellness Visit.

Read the FAQ »


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Requirements and provisions for G0438 (initial visit) include:

  • Billable for the first AWV only.
    • Patient is eligible after the first 12 months of Medicare coverage.
    • For services within the first 12 months, conduct the Initial Preventive Physical Exam (IPPE) (G0403).
  • Administer a Health Risk Assessment (HRA) that includes: demographic data, self-assessment of health status, psychosocial and behavioral risks, and activities of daily living.
  • Establish the patient’s medical and family history.
  • Establish a list of current physicians and providers that are regularly involved in the medical care of the patient.
  • Obtain blood pressure, height, weight, body mass index or waist circumference, and other measurements, as deemed appropriate.
  • Assess patient’s cognitive function.
  • Review risk factors for depression, including current or past experiences with depression or mood disorders.
  • Review patient’s functional ability and safety based on direct observation or the use of appropriate screening questions.
  • Establish a written screening schedule for the individual, such as a checklist for the next 5 to 10 years based on appropriate recommendations.
  • Establish a list of risk factors and conditions for primary, secondary, or tertiary intervention.
  • Provide personalized health advice to the patient, as appropriate, including referrals to health education or preventive counseling services and programs.
  • Other element determined appropriate by the Secretary of Health and Human Services (HHS).

Talk to Your Medicare Patients about AWV

Better patient care starts with preventive wellness visits. Download the AAFP’s patient flier and use it to talk with your Medicare patients about the importance of scheduling a free, personalized prevention visit with you.

Download the patient flyer »(1 page PDF)

FPM Medicare Wellness Visit Toolkit

This downloadable PDF includes previously published tools from FPM for use in providing Medicare wellness visits that benefit your patients and your practice.

Buy Now »

Requirements and provisions for G0439 (subsequent visit) include:

  • Billable for subsequent AWV.
  • Update the HRA.
  • Update the patient’s medical and family history.
  • Update the current physicians and providers that are regularly involved in providing the medical care to the patient, as developed during the first AWV.
  • Obtain blood pressure, height, weight, body mass index or waist circumference,  and other measurements, as deemed appropriate.
  • Assess patient’s cognitive function.
  • Update the written screening schedule checklist established in the initial AWV.
  • Update the list of risk factors and conditions for which primary, secondary, and tertiary interventions are recommended or underway.
  • Provide personalized health advice to the patient, as appropriate, including referrals to health education or preventive counseling services and programs.
  • Other elements determined appropriate by the Secretary of Health and Human Services (HHS).

AAFP Position on AWVs

The AAFP supports this preventive coverage as it provides an opportunity to deliver, document, and bill for the service. Implementing the service allows physicians to invest in patient-centered, team-based care while promoting quality and cost-effective care.

What Members Need to Know

The AWV may be provided by a physician, physician assistant, nurse practitioner, clinical nurse specialist, medical professional (including a health educator, registered dietician, or nutrition professional or other licensed practitioner), or a team of medical professionals working under the direct supervision of a physician. It is important to remember that CPT code G0438 is for the first AWV only. The submission of G0438 for a beneficiary for which a claim code of G0438 has already been paid will result in a denial. This benefit is covered at 100% for the beneficiary.

FPM Medicare Wellness Visit Toolkit

This downloadable PDF includes previously published tools from FPM for use in providing Medicare wellness visits that benefit your patients and your practice.

Buy Now »