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Wednesday Feb 26, 2020

Two reasons to provide Medicare annual wellness visits

Less than 16 percent of Medicare patients had an annual wellness visit (AWV) between 2011, the year Medicare began covering the benefit, and 2014.1

There were a number of possible reasons for that, including the challenge of providing and documenting all of the essential elements of an AWV efficiently. But these visits have many benefits for patients and practices, including the following:

1. The formation of a personalized prevention plan for the next five to 10 years. That plan helps ensure that your Medicare patients are on schedule for the age-appropriate screenings(www.uspreventiveservicestaskforce.org) recommended by the U.S. Preventive Services Task Force and the vaccines recommended(www.cdc.gov) by the Advisory Committee on Immunization Practices. It also includes personalized health advice that identifies risk factors and suggests referrals or programs to address them.

2. Increased practice revenue. When billed correctly and delivered efficiently with other covered Medicare services, AWVs can also increase practice revenue. For example, in 2019 the unadjusted allowable charge for code G0438, an initial AWV, was $174, and its work relative value units (RVUs) were 2.43, compared with 1.5 work RVUs for a 99214.

1. Ganguli I, Souza J, McWilliams JM, Mehrotra A. Trends in use of the U.S. Medicare annual wellness visit, 2011–2014. JAMA. 2017;317(21):2233–2235.


Read the full FPM article: “Medicare Wellness Visits: Reassessing Their Value to Your Patients and Your Practice.”

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Posted at 08:00PM Feb 26, 2020 by FPM Editors

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