welcome to medicare visit aafp

You and your patient have a lot of ground to cover. Here’s one way to get it all done .

RANDALL O. CARD, MD, FAAFP

Fam Pract Manag. 2005;12(4):27-31

The new Welcome to Medicare exam revolves around preventive health care, something family physicians have always incorporated into their practice. But as you work out your routine for performing these visits, you might need to reframe your thinking about what constitutes a physical exam.

The new Medicare exam includes seven elements, and they add up to a patient encounter that is as much of a conversation as it is a physical exam. Making sure you cover all of the required elements in the allotted time takes a well-planned routine. If you haven’t already developed such a routine, this article suggests some time-saving strategies. The encounter form in this article will help you to ensure all elements of the initial preventive physical exam are completed. The form also should help you meet evaluation and management (E/M) documentation requirements.

The essential elements

As part of the Medicare Modernization Act (MMA), Medicare beneficiaries whose Part B coverage began after Jan. 1, 2005, and who are within six months of the effective date of their coverage are eligible for one initial preventive physical exam. The exam focuses on identifying modifiable risk factors for medical conditions that frequently affect the elderly, as well as education, counseling and referral for Medicare-covered preventive services.

Here are the seven required elements:

1. Review of comprehensive medical and social history. The purpose of this element is to identify modifiable risk factors for disease.

The medical history component should include illnesses, hospitalizations, surgeries, injuries, allergies, medications, supplements and vitamins. Social issues to address include alcohol, tobacco and illicit drug use; diet; and physical activities. The family history is performed to identify hereditary diseases or diseases that otherwise place the patient at increased risk for disease.

2. Review of risk factors for depression. This next element involves identifying depression and other mood disorders. The Centers for Medicare & Medicaid Services (CMS) does not recommend a specific depression screening tool. Instead, CMS states that you “may select from various available standardized screening tests designed for this purpose.” 1

Many standardized depression screening tools are too cumbersome to use in a short office visit. One quick technique recommended by the U.S. Preventive Services Task Force (USPSTF) involves asking two questions: “Over the past two weeks, have you felt down, depressed or hopeless?” and “Over the past two weeks, have you felt little interest or pleasure in doing things?” An affirmative answer to either may be as effective as more detailed instruments in identifying a patient who needs further evaluation for depression. 2

BILLING FOR A WELCOME TO MEDICARE VISIT

Along with settling on a new routine for the Welcome to Medicare exam, you’ll also want to make sure you understand its billing requirements.

For a complete overview, see “New Year, New Medicare Benefits,” FPM, February 2005, page 15 .

3. Review of functional ability and level of safety. You have a lot of leeway with this element, which requires you to evaluate your patient’s hearing, activities of daily living, functional ability and level of safety. As with the depression screening, CMS accepts any appropriate screening test that is recognized by national medical professional groups.

For determining fall risk, I recommend following the American Geriatrics Society’s (AGS) clinical guidelines. According to the AGS, there are two tests that should trigger further patient evaluation: if your patient previously has received treatment for a fall, or if your patient takes longer than 30 seconds for an “Up & Go” test. 3

The timed Up & Go test involves having the patient stand up from a chair, walk three meters, turn around, walk back to the chair and sit back down. If the patient takes longer then 30 seconds or seems unsteady, the test is considered positive for increased fall risk.

To identify functional challenges, the CDC advises screening your patients by inquiring about their instrumental activities of daily living (IADLs). This involves asking patients about troubles using a phone, using transportation, grocery shopping, preparing meals, doing housework, doing laundry, taking medications and managing money. Any limitation to their IADLs that you identify as being caused by a chronic condition warrants further evaluation.

While functional assessments have been researched extensively, less evidence exists for home safety screening. The CDC recommends that elderly patients improve home safety by removing tripping hazards in walkways, using non-slip mats in bathtubs and showers, placing grab bars next to the toilet and shower, placing handrails on both sides of a stairway and improving home lighting. It seems reasonable to question patients about these items during the initial preventive physical exam.

For the hearing evaluation, I plan to follow the USPSTF’s recommendation to simply question patients about their hearing function. There are, of course, more elaborate testing methods, but the USPSTF found insufficient evidence to recommend for or against them. 4

Your screening for depression risk, functional ability and level of safety should be accompanied by further evaluation, including a full diagnostic workup, for any patients with positive responses. The workup can be performed in conjunction with the initial preventive physical exam, or the patient can be further evaluated later. CMS will allow a level-one or level-two E/M code with a -25 modifier attached to be billed with the initial preventive physical exam. If you conclude that the depression or fall risk does not warrant immediate care but will require a level-three or higher E/M service, it might be prudent to perform the full workup at a later date.

4. A focused physical exam. This should be an extremely focused physical exam. Height, weight, blood pressure and visual acuity are the only required components. No specific vision tests are mandated, but using the Snellen chart is appropriate.

5. Performance and interpretation of an electrocardiogram. Some offices have the capacity to handle this, and others will need to send the patient to another facility. Either way, the ECG results need to be incorporated into your patient’s medical record to complete the initial preventive physical exam.

If the patient is sent to another facility for the ECG, the order must read “ECG as part of the Welcome to Medicare Physical, codes G0366–G0368.” Medicare has instructed that physicians must order the ECG in a manner that helps to prevent use of codes for ECGs not related to the initial preventive physical exam.

6. Brief education, counseling and referral to address any pertinent health issues identified during the first five elements of the exam. CMS expects the amount of time required for this step to vary depending on the problems that you discovered in the first five elements.

7. Brief education, counseling and referral, with maintenance of a written plan (such as a checklist), regarding separate preventive care services covered by Medicare Part B. There are now 11 preventive services authorized under Medicare Part B. Coverage for the two newest ones, cardiovascular disease screening and diabetes screening, became effective on Jan. 1, 2005. For the full list, see “Preventive services covered by Medicare Part B.”

It is important that you thoroughly understand Medicare’s policy on these services before counseling your patient. Some services are covered at 100 percent of the Medicare allowable charge, and some services are covered at 80 percent of the Medicare allowable charge. In addition, some of the services are covered only if medically indicated.

Kent J. Moore, AAFP’s manager for health care and delivery systems, has written two FPM articles that cover these Part B services. “Another Ounce of Prevention” ( November/December 2002, page 25 ) covers most of the benefits, and “New Year, New Medicare Benefits” ( February 2005, page 15 ) summarizes the two new ones.

PREVENTIVE SERVICES COVERED BY MEDICARE PART B

Pneumococcal, influenza and hepatitis B vaccines

Screening mammography

Screening Pap smear/pelvic exam

Prostate cancer screening

Colorectal cancer screening

Diabetes outpatient self-management training services

Bone mass measurements

Screening for glaucoma

Medical nutritional therapy for individuals with diabetes or renal disease

Cardiovascular screening blood tests

Diabetes screening tests

Put it in writing

A checklist or another method of documentation indicating that the seven elements of the initial preventive physical exam have been addressed must be maintained in the patient record. The encounter form has been designed to do that.

In addition, you are required to give your patient a written plan for obtaining the appropriate preventive services. I suggest that you make a copy of the form’s second page to give to the patient at the exam’s conclusion. If you want to get fancy, you could design a similar form with a duplicate page two, allowing you to keep the original and give the carbon copy to the patient.

MEDICARE INITIAL PREVENTIVE PHYSICAL EXAMINATION ENCOUNTER FORM

This form has been updated since its original publication date to reflect changes to Medicare's covered services. You can download the updated encounter form as a PDF here.

A timed exchange

Over time, you will become more adept at completing the initial preventive physical exam in a reasonable period. CMS considers the physician/non-physician provider time component of the initial preventive physical exam to be equivalent to a 30-minute 99203 (new patient, level-three E/M code).

To speed the process along, you could use preprinted patient education materials to counsel your patient. For some specific examples available on Familydoctor.org, AAFP’s patient education Web site, see “Preprinted handouts.” It would also be helpful to ask your patients to bring to the visit the “Guide to Medicare’s Preventive Services,” which each new beneficiary is receiving in their Welcome to Medicare package. It can be viewed or downloaded at https://www.medicare.gov/Pubs/pdf/10110.pdf .

PREPRINTED HANDOUTS

Familydoctor.org has patient education materials regarding many of the preventive health issues covered in an initial preventive physical exam.

Breast cancer screening

https://familydoctor.org/familydoctor/en/diseases-conditions/cancer/diagnosis-tests.html

Cardiovascular blood tests

https://familydoctor.org/029.xml

Colon cancer screening

https://familydoctor.org/familydoctor/en/diseases-conditions/colorectal-cancer/diagnosis-tests.html

Diabetes screening

https://familydoctor.org/familydoctor/en/diseases-conditions/diabetes/diagnosis-tests.html

https://familydoctor.org/familydoctor/en/diseases-conditions/glaucoma/diagnosis-tests.html

Osteoporosis

https://familydoctor.org/familydoctor/en/diseases-conditions/osteoporosis/diagnosis-tests.html

https://familydoctor.org/familydoctor/en/diseases-conditions/prostate-cancer/diagnosis-tests.html

Screening Pap/pelvic

As you perfect your Welcome to Medicare exam routine, you should also refine how your office handles this new Medicare benefit before patients are even in the exam room. Identify new Medicare-eligible patients. Schedule the patients in a timely manner. Perform some of the screening before the face-to-face encounter.

The initial preventive physical exam is an opportunity for you and your newly enrolled Medicare patients to start thinking about Medicare-covered preventive services. Effective, efficient use of the initial preventive physical exam requires physicians and non-physician providers to understand the specific components of the initial preventive physical exam. A systems approach to identifying, educating and counseling patients regarding Medicare-covered preventive services may improve patient health and help physicians deliver the initial preventive physical exam in a financially sound manner.

CMS Manual System. Pub. 100–04 Medicare claims processing. Dec. 22, 2004.

U.S. Preventive Services Task Force. Screening for depression: recommendations and rationale. Ann Intern Med . 2002;136:760-764.

Kenny RA, Rubenstein LZ, Martin FC, et al. Guideline for the prevention of falls in older persons. J Am Geriatr Soc . 2001;49:664-672.

U.S. Preventive Services Task Force. Screening for hearing impairment. In: Guide to clinical preventive services: a report of the U.S. Preventive Services Task Force. 2nd ed. Baltimore: Williams & Wilkins; 1996:393–405.

Continue Reading

What is the Welcome to Medicare checkup?

| You can get one free Welcome to Medicare checkup anytime during the first 12 months after you enroll in Medicare Part B , which is the part of Medicare that covers doctor visits and outpatient services. This checkup is not a comprehensive physical exam but is an opportunity for your doctor to assess your health and provide a plan of future care.

The Welcome to Medicare checkup is optional, but it serves as a baseline for monitoring your health during the annual wellness visits that Medicare will pay for in subsequent years. You do not need this checkup to qualify for later annual wellness visits, but Medicare won’t pay for a wellness visit during your first 12 months in Part B.

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What happens at the Welcome to Medicare checkup?

During the exam you can expect your doctor to do the following:

Record your vital information, including blood pressure, height and weight.
Calculate your Body Mass Index (BMI).
Review your health history — your own and that of your family.
Determine your ability to function independently and your level of safety, such as how well you perform activities of daily living and your risk of falls.
Assess your potential for depression.
Check for risk factors that could indicate future serious illnesses.
Provide a simple vision test.
Recommend screenings, shots and other preventive services in writing that you may need to stay healthy. Many of these, such as mammograms and vaccinations, may be free under Medicare.
Offer to talk about advance directives . A health care proxy lets you designate someone else to make medical decisions on your behalf if you can’t, and a living will specifies your preferences for medical treatment at the end of your life.

How can I prepare for my Welcome to Medicare visit?

To make the most of this appointment, you should gather the following information and records in advance:

Your family medical history Learn as much as you can about your blood relatives’ health history. Any information you can give your doctor can help determine if you are at risk for inherited diseases.
Your personal medical records That includes providing immunization records if you’re seeing a new doctor.
Your prescription medications Along with listing the names of your drugs, include dosage, how often you take each medication and why.

How much will I pay for a Welcome to Medicare checkup?

You’ll have no deductible or copayment for the Welcome to Medicare checkup if you meet the following conditions:

If you’re enrolled in original Medicare, you need to go to a doctor who accepts “assignment,” meaning that the physician accepts the Medicare-approved amount as full compensation.

If you’re enrolled in a Medicare Advantage plan that has a provider network, such as an HMO or PPO , you may need to go to a doctor in the plan’s provider network.

Keep in mind

Even though you won’t have to pay for this checkup, the doctor could order other tests or procedures for which you may have to cover deductibles and copayments out of pocket.

Updated June 22, 2022

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The Welcome to Medicare preventive visit is a one-time appointment you can choose to receive when you are new to Medicare. The aim of the visit is to promote general health and help prevent diseases.

Eligibility

Medicare Part B covers your one-time Welcome to Medicare preventive visit. Note that you must receive this visit within the first 12 months of your Part B enrollment .

Covered services

During the course of your Welcome to Medicare preventive visit, your provider should:

Check your height, weight, blood pressure, body mass index (BMI), and vision
Review your medical and social history
Review your potential for depression and other mental health conditions
Review your ability to function safely in the home and community
Provide you with education, counseling, and referrals related to your risk factors and other health needs
Give you a checklist and/or written plan with information about other preventive services you may need

The Welcome to Medicare preventive visit is not a head-to-toe physical. This visit is also separate from the Annual Wellness Visit (AWV) , which you can choose to receive once each year.

Original Medicare covers the Welcome to Medicare preventive visit at 100% of the Medicare-approved amount when you receive the service from a participating provider . This means you pay nothing (no deductible or coinsurance ). Medicare Advantage Plans are required to cover this visit without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.

During the course of your preventive visit, your provider may discover and need to investigate or treat a new or existing problem. This additional care is considered diagnostic, meaning your provider is treating you because of certain symptoms or risk factors. Medicare may bill you for any diagnostic care you receive during a preventive visit.

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Initial Preventive Physical Examination

The Affordable Care Act provides for an initial preventive physician exam (IPPE) also known as the "Welcome to Medicare" preventative visit, for Medicare beneficiaries as of January 1, 2011. Medicare pays for one IPPE visit per lifetime that must be completed no later than 12 months after the patient’s Medicare Part B eligibility date. You should ensure your billing staff are aware of these services and how to bill for them.

Coding and Billing an IPPE

G0402: Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment
G0403: Electrocardiogram, routine ECG with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report
G0404: Electrocardiogram, routine ECG with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination
G0405: Electrocardiogram, routine ECG with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination
G0468: Federally qualified health center (FQHC) visit, IPPE, or AWV, a FQHC visit that includes an initial preventive physical examination (IPPE) or annual wellness visit (AWV) and includes a typical bundle of Medicare-covered services that would be furnished per diem to a patient receiving IPPE or AWV

For more details about how to bill these codes, see module 9 of Coding for Clinicians.

Your “Welcome to Medicare” Visit Checklist

Written by Ari Parker — Updated: Tuesday, March 19, 2024

Older couple looking through checklist items

Check off what you should ask, what to schedule, and how to prepare for your “Welcome to Medicare” visit

Planning for health insurance and maintaining a regular schedule for doctor visits should be a priority for retirees. When you first enroll in Medicare, you have access to a free “Welcome to Medicare” preventive visit once within the first 12 months after you enroll in Part B.

This visit is a great opportunity to understand and take advantage of the preventive services covered by Medicare Part B. If you’re new to Medicare, we’ve prepared a checklist for you to get ready for your Welcome to Medicare visit.

Key takeaways:

If you’re new to Medicare, you have a free “Welcome to Medicare” visit once within the first 12 months after your Part B coverage starts.

This visit is a good time to ask your provider about your health conditions, understand what preventive screenings and vaccines to schedule, and take control of your healthcare.

After your first 12 months of Part B coverage, you get one free “Wellness” visit each year .

What is the Welcome to Medicare visit?

For beneficiaries who are new to Medicare, the Welcome to Medicare visit is an opportunity to take control of your health by talking to your doctor about any concerns, reviewing your medical history, and understanding your options for preventive services that are covered by Medicare. This visit is free and you can schedule it within the 12 months after your Part B coverage begins.

Keep in mind that the Welcome to Medicare visit is not typically a comprehensive physical exam or a head-to-toe assessment. Instead, it focuses on preventive care and education to help you stay healthy and catch potential health issues early on.

While the visit itself won’t cost you a dime, you may have to pay a copay or coinsurance if your healthcare provider performs additional services during the same appointment.

What to expect during the Welcome to Medicare visit

During the Welcome to Medicare visit, your doctor will typically review your medical history, assess your current health status, and provide personalized health advice and information, especially around preventive screenings.

The visit may include:

Discussing your medical and family history

Measuring your height, weight, blood pressure, and other routine vitals

Assessing risk factors for certain diseases

Recommendations for preventive screenings

Reviewing which vaccinations you’ve received and recommendations for vaccinations you may need

Conducting a simple vision test

Referrals for care

Evaluating your mental health

Counseling on living a healthy lifestyle, including diet and exercise

Explaining the various preventive services covered by Medicare, such as screenings for cancer, cardiovascular disease, and diabetes

Consultation about creating advance directives (how you want to make medical decisions if you can’t speak for yourself)

The Welcome to Medicare visit empowers you to take charge of your healthcare by evaluating your current health and developing a plan for ongoing preventive care.

Checklist one: preparing for the Welcome to Medicare visit

Compile your medical history: Be prepared to share your medical history with your healthcare provider, and include details about past and present medical conditions. Share details about surgeries, hospitalizations, and other major health events. Be ready to discuss any conditions that run in your family as well.

Make a list of your medications: Your doctor will ask you if you’re taking any medications currently. Make a comprehensive list of all the drugs you’re taking, including prescriptions, over-the-counter medications, and supplements. It’s helpful for your doctor to know the dosage, frequency, and reason for taking each medication too.

Gather relevant health documents: You’ll need your Medicare card and any other insurance cards you have. If you have information about advance directives or living wills, you can bring that for discussion. Bring other relevant medical records in case they come in handy.

Prepare questions to ask your provider: Take some time to consider or write down questions you have about your health. This is a time for you to take care of your present and future health. Ask about what your doctor recommends for you to prevent or manage specific health concerns.

Note any health concerns currently: Whether mental or physical, take note of symptoms you’ve been experiencing or recent changes in your health. Your doctor may also ask you about your daily habits, like exercise, diet, and sleep patterns.

Checklist two: follow-up after the Welcome to Medicare visit

Review recommendations from your doctor: Take time to understand your doctor’s recommendations and then make a list of your next steps. It could be scheduling preventive screenings , booking an appointment for a vaccination, or implementing lifestyle changes.

Schedule follow-up appointments: If your healthcare provider recommended any follow-up screenings or tests, schedule these appointments promptly. Avoid delays to catch and prevent conditions early on.

Update your medication list: Implement any medication changes into your routine if your doctor recommended changes to your prescriptions. Monitor for any side effects or challenges with the medication.

Understand your Medicare benefits: Knowing your Medicare benefits for preventive care can help you prevent health challenges in the future. Medicare has comprehensive coverage for screenings, vaccines, and tests, so you can take full advantage of your coverage. You can also get one free “Wellness” visit each year .

Keep it up : Continue to implement lifestyle changes and schedule preventive measures. Routine doctor visits can also ensure that you live a long and healthy life.

By following these checklists, you can play a proactive role in managing your health and ensuring that you receive timely care to maintain your well-being.

If you have more questions about Medicare, you can ask your provider during your Welcome to Medicare visit or you can get in touch with a Chapter Medicare Advisor. An Advisor can help you thoroughly understand your plan so that you can use your benefits to their full extent.

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COMMENTS

How to Conduct a "Welcome to Medicare" Visit
Either way, the ECG results need to be incorporated into your patient's medical record to complete the initial preventive physical exam. If the patient is sent to another facility for the ECG ...
What Is the Welcome to Medicare Checkup Visit?
The Welcome to Medicare checkup is optional, but it serves as a baseline for monitoring your health during the annual wellness visits that Medicare will pay for in subsequent years. You do not need this checkup to qualify for later annual wellness visits, but Medicare won't pay for a wellness visit during your first 12 months in Part B.
MLN6775421
Annual Wellness Visit (AWV) Visit to develop or update a personalized prevention plan and perform a health risk assessment. Covered once every 12 months. Patients pay nothing (if provider accepts assignment) Routine Physical Exam. Exam performed without relationship to treatment or diagnosis of a specific illness, symptom, complaint, or injury.
Welcome to Medicare Visit
The Welcome to Medicare visit is a one-time preventive care exam that is entirely paid for by your Medicare benefits within the first 12 months of you enrolling in coverage. During this appointment, your physician will review your current health status and your health history. They will also perform necessary health screenings to help determine ...
Welcome to Medicare preventive visit
The Welcome to Medicare preventive visit is a one-time appointment you can choose to receive when you are new to Medicare. The aim of the visit is to promote general health and help prevent diseases. Eligibility. Medicare Part B covers your one-time Welcome to Medicare preventive visit. Note that you must receive this visit within the first 12 months of your Part B enrollment.
PDF Are You Up-To-Date on Your Medicare Preventive Services?
One time "Welcome to Medicare" preventive visit—get this visit within the first 12 months you have Medicare Part B (Medical Insurance) Yearly "Wellness" visit—get this visit 12 months after your "Welcome to Medicare" preventive visit or 12 months after your Part B coverage starts Abdominal aortic aneurysm screenings
"Welcome to Medicare" Exam
Initial Preventive Physical Examination. The Affordable Care Act provides for an initial preventive physician exam (IPPE) also known as the "Welcome to Medicare" preventative visit, for Medicare beneficiaries as of January 1, 2011. Medicare pays for one IPPE visit per lifetime that must be completed no later than 12 months after the patient's ...
Preventive Visit Coverage
During this visit, your doctor or other health care provider will: Review your medical and social history related to your health. Give you information about preventive services, including certain screenings, shots or vaccines (like flu, pneumococcal, and other recommended immunizations). Take height, weight, and blood pressure measurements.
PDF Scheduling Resource for Medicare Wellness Visits
Medicare pays 100%. Initial AWV covered 12 months after enrollment in Medicare or 12 months after the Wel-come to Medicare visit. Subse-quent AWVs may be provided annually. A focused physical exam, review of the patient's health, and development of a plan to keep the patient healthy. Not a comprehensive, "head-to-toe" physical.
'Welcome to Medicare' physical: What to know
The "Welcome to Medicare" physical only takes place during the initial 12 months of enrolling. It is a one-time health assessment. After someone has had Medicare Part B for more than 12 months ...
Your "Welcome to Medicare" Visit Checklist · Chapter Medicare
When you first enroll in Medicare, you have access to a free "Welcome to Medicare" preventive visit once within the first 12 months after you enroll in Part B. This visit is a great opportunity to understand and take advantage of the preventive services covered by Medicare Part B. If you're new to Medicare, we've prepared a checklist ...
PDF Welcome to Medicare
To make sure your bills are paid correctly, tell Medicare about your other insurance by calling Medicare's Benefits Coordination & Recovery Center at 1-855-798-2627. TTY users can call 1-855-797-2627. You can also learn more by visiting go.medicare.gov/ other-insurance. Get help paying your Medicare health and drug costs.
Standardized Patient Assessments at the Medicare Annual Wellness Visit
Introduction: The Centers for Medicare and Medicaid Services (CMS) has set requirements for the Medicare Annual Wellness Visit (AWV). Methods: A cross-sectional online survey to explore the variability in assessments and tools used during the AWV was completed by 159 primary care providers from 145 practices in 36 states. Results: The results confirmed wide variation in use of specific tools ...
PDF Frequently Asked Questions from the March 28, 2012 Medicare Preventive
While CMS encourages health care providers to furnish the Initial Preventive Physical Exam (IPPE) or Annual Wellness Visit (AWV) services to Medicare beneficiaries, as appropriate, they are not required to furnish these services. Both the IPPE and AWV are statutorily defined benefits. The Initial Preventive Physical Exam (IPPE), also commonly ...
PDF Reimbursement and Coding for Lifestyle Medicine-related Services
G0439 Annual wellness visit; includes a personalized prevention plan of service, subsequent visit Medicare: The IPPE (also known as Welcome to Medicare) visit is a one-time service available to Medicare beneficiaries within their first 12 months of Medicare enrollment. After the first 12 months, beneficiaries are eligible for an AWV.
PDF Thank you for scheduling an upcoming "Welcome to Medicare Visit" or
Tell us if you are in your first year of Medicare eligibility so that we can give you the proper forms and file the correct codes to Medicare. Be organized and ready when you see the doctor. Bring your medicines with you and make a list of concerns you have had since your last appointment.
PDF The Annual Wellness Visit for Medicare Beneficiaries
Billing for Annual Wellness Visit. Subsequent AWV G0439 (average reimbursement $111) Payable: every 12 months V70.0 is the diagnosis to use E/M services are reported in addition to the AWV using CPT codes 99201-99215. Practices should consider append modifier 25 to the E/M service code if appropriate.
Aetna Medicare
Review our Medicare Supplement Insurance plans. 87% of Aetna® Medicare Advantage members are in 4-star plans or higher for 2024. Every year, Medicare evaluates plans based on a 5-star rating system. Read the latest press release on our Star Ratings for 2024 and our ongoing commitment to improving health outcomes for members.