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What Happens During a Wellness Visit?

Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

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Importance of a Wellness Visit

• What to Expect
• How to Prepare

A wellness visit is a health check-up that is typically conducted on an annual basis. It involves visiting your healthcare provider to check your vitals, screen for health conditions , and develop a healthcare plan for your needs.

The aim of a wellness visit is to promote health and prevent disease and disability.

This article explains why annual wellness visits are important, what you can expect during the process, and how to prepare for it.

These are some reasons why wellness visits are important.

Prevent Diseases

Most healthcare visits are categorized under diagnostic care; when you have a health problem, you visit a healthcare provider who assesses your symptoms, diagnoses your condition, and prescribes a treatment plan.

A wellness visit on the other hand is a preventative healthcare measure. The aim of preventative healthcare is to help you maintain good health and prevent health problems before they develop. The goal is to help you live a longer, healthier life.

Wellness visits assess your lifestyle, evaluate health risks, and screen for health conditions, in order to prevent health problems or catch them in the early stages. Instead of waiting to see a healthcare provider once you have a health problem, the idea is to be proactive about your health and work with your healthcare provider to prevent health problems.

People tend to think that it’s fine to skip their annual wellness visit if they’re feeling healthy. However, a 2021 study notes that wellness visits can play a role in catching chronic health conditions early, as well as helping people control for risk factors that could cause them to develop health issues down the line.

Reduce Medical Costs

Wellness visits can help prevent disease and disability, which in turn can help reduce medical costs. According to a 2016 study, a focus on preventive healthcare can significantly reduce medical costs and improve the quality of healthcare services.

What to Expect During a Wellness Visit

A wellness visit may be performed by a healthcare provider such as a doctor, nurse practitioner, clinical nurse specialist, physician assistant, or other qualified health professional.

These are some of the steps a wellness visit may involve:

• Family history: Your healthcare provider may ask you detailed questions about your family’s medical history, to determine whether you are at an increased risk for certain health conditions that may be passed on genetically .
• Medical history: You may also be asked questions about your personal medical history. It can include information about any current or previous diseases, allergies, illnesses, surgeries, accidents, medications, vaccinations, and hospitalizations, as well as the results of any medical tests and examinations.
• Measurements: Your healthcare provider may measure your height, weight, heart rate, blood pressure, and other vital signs. Doing this regularly can help you establish a baseline as well as track any changes in your health.
• Cognitive assessment: Your healthcare provider may assess your ability to think, remember, learn, and concentrate, in order to screen for conditions such as Alzhemer’s disease and dementia.
• Mental health assessment: Your healthcare provider may also assess your mental health and state of mind, to help screen for conditions such as depression and other mood disorders.
• Physical assessment: Your healthcare provider may perform a physical examination to check your reflexes. They may also perform a neurological exam, a head and neck exam, an abdominal exam, or a lung exam.
• Functional assessment: Your healthcare provider may assess your hearing, your vision, your ability to perform day-to-day tasks, your risk of falling, and the safety of your home environment.
• Lifestyle factors: Your healthcare provider may ask you questions about your nutrition, fitness, daily habits, work, stress levels, and consumption of substances such as tobacco, nicotine, alcohol, and drugs.
• Health risk assessment: Based on this information, your healthcare provider will evaluate your health, and determine whether you are at an increased risk for any health conditions.
• Health advice: Your healthcare provider may advise you on steps you can take to improve your health, control risk factors, and prevent disease and disability. This may include nutrition counseling, an exercise plan, flu shot and vaccination recommendations, and fall prevention strategies, among other things.
• Screenings: Your healthcare provider may recommend that you get screened for certain health conditions such as depression , cholesterol, blood pressure, diabetes, cancer, heart disease, or liver conditions. This may involve blood work, imaging scans, or other screening tests. 
• Medication review: Your healthcare provider may review your medication and adjust it, if required. This can include prescription medication, over-the-counter medication, vitamins, supplements, and herbal or traditional medication.
• Referrals and resources: If required, your healthcare provider will provide a referral to other healthcare specialists. They can also provide other resources that may be helpful, such as counseling services or support groups , for instance.
• Medical providers: Your healthcare provider will work with you to create or update a list of your current medical providers and equipment suppliers. This list can be helpful in case of an emergency.
• Healthcare plan: Your healthcare provider will work with you to create a healthcare plan that is tailored to your needs. The plan will serve as a checklist that will list any screenings or preventive measures you need to take over the next five to 10 years.

The screenings, assessments, and healthcare plan can vary depending on factors such as your age, gender, lifestyle, and risk factors.

How to Prepare for a Wellness Visit

These are some steps that can help you prepare for a wellness visit:

• Fill out any required questionnaires: Your healthcare provider may ask you to fill out a questionnaire before your visit. The questionnaire may include some of the factors listed above. Make sure you do it before your visit, so that you can make the most of your time with your healthcare provider.
• Carry your medications: If possible, try to carry your medications with you to show them to your healthcare provider.
• Take your medical documents along: It can be helpful to carry your prescriptions, immunization records, as well as the results of any medical tests or screenings you have had, to help give your healthcare provider a more accurate picture of your health status.
• Ask someone to go with you: You may want to take a trusted friend or family member along with you for the wellness visit. They can assist you if required, take notes for you, ask questions, and help you remember your healthcare provider’s instructions.
• Note down questions and concerns: A wellness visit is a good opportunity to ask your healthcare provider any questions you have about your health and tell them about any health problems or concerns you have. Making a list and carrying it with you to the visit can help ensure that you don’t miss anything.
• Check your insurance plan: Most insurance plans cover wellness visits; however, what is covered as part of the wellness visit can vary depending on the plan. It can be helpful to know what preventative services and wellness visits your plan offers. It’s important to check that your healthcare provider takes your insurance and to inform them that you’ll be coming for a wellness visit when you schedule your appointment.

A Word From Verywell

A wellness visit can help you evaluate your health status, understand your risk for specific health conditions, and give you the information and resources you need to improve your health.

After you go for a wellness visit, it’s important that you start implementing your healthcare provider’s advice, take any follow-up appointments necessary, and take steps to improve your health.

U.S. Department of Health and Human Services. Get your wellness visit every year .

University Hospitals. What you need to know about wellness visits .

Liss DT, Uchida T, Wilkes CL, Radakrishnan A, Linder JA. General health checks in adult primary care: a review . JAMA . 2021;325(22):2294-2306. doi:10.1001/jama.2021.6524

Musich S, Wang S, Hawkins K, Klemes A. The impact of personalized preventive care on health care quality, utilization, and expenditures . Popul Health Manag . 2016;19(6):389-397. doi:10.1089/pop.2015.0171

Alzheimer’s Association. Annual wellness visit .

University of Michigan Health. Your yearly wellness visit .

By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

What is the difference between a physical exam and a Medicare Wellness Visit?

Published by Medicare Made Clear®

The difference between a physical exam and a Medicare Wellness Visit is basically the difference between your doctor focusing on what’s wrong versus on what’s right. Each is important, depending on the situation.

When you’re sick or in pain, you want to get better. A physical exam helps your doctor figure out what the problem is and what needs to be done.

When you’re healthy and feeling good, you want to stay that way. A wellness exam helps your doctor understand what’s working for you and how to best support your continued health and well-being.

Your doctor performs specific tasks in each of these two exams in order to achieve its purpose. See below for a chart that lists some of the services that may be covered in a physical exam versus a Medicare wellness visit, or that may be covered in both.

NOTE: this chart is not complete and you should ask your physician what is covered and your Medicare plan provider to understand how different health services may or may not be covered.

What’s included in a physical exam?

An annual physical exam is an assessment of your body’s health. The primary purpose is to look for health problems.

During the exam, your doctor uses his or her senses – mainly sight, touch and hearing – to gauge how your body is performing. Based on what’s learned, your doctor may ask you to have tests to discover or rule out possible health problems.

The list below shows some of the things your doctor may do during a physical exam.

Visually check your body overall for signs of existing health issues

Look into your eyes, ears, nose and throat for potential problems

Listen to your heart and lungs to detect irregular sounds

Touch parts of your body to feel for abnormalities

Test your motor function and reflexes

Perform pelvic and rectal exams

Measure your height, weight and blood pressure

As a rule, Medicare does not cover an annual physical. The exam and any tests your doctor orders are separate services, and you may have costs related to each depending on your Medicare plan.

What’s included in a Medicare Wellness Visit?

A Medicare Wellness Visit, also called a wellness exam, is an assessment of your overall health and well-being. The primary purpose is prevention – either to develop or update your personalized prevention plan. Medicare covers a wellness visit once every 12 months (11 full months must have passed since your last visit), and you are eligible for this benefit after you have had Part B for at least 12 months.

During the exam, your primary care provider combines information from the visit with your medical record to gauge your risk for common preventable health problems such as heart disease, cancer and type 2 diabetes. Based on what’s learned, your doctor creates your personal prevention plan with a checklist of screenings you need to have.

The list below shows some of the things your doctor may do during a wellness exam.

Review your health risk assessment (questions you answer about your health)

Confirm your medical and family history

Record your current prescriptions and providers

Measure and document your height, weight, and blood pressure

Look for signs of memory loss, dementia, or frailty

Document your health risk factors and treatment options

Provide personalized health advice

Develop a screening schedule (like a checklist) for the preventive services recommended for you

Medicare Part B covers an annual wellness exam and many preventive screenings with no copay or deductible. However, you may have to pay a share of the cost for certain recommended tests or services. And while it’s not mandatory, there are very good  reasons to have a wellness exam  every year.

What is a "Welcome to Medicare" visit?

Medicare Part B covers a "Welcome to Medicare" visit. This visit is also called an Initial Preventive Physical Exam (IPPE). You are eligible for this benefit once within the first 12 months you are enrolled in Part B

What to expect at your "Welcome to Medicare" visit

During the visit your provider will:

Record and evaluate your medical and family history, current health conditions and prescriptions.

Check your blood pressure, vision, weight and height to get a baseline for your care.

Make sure you are up-to-date with preventive screenings and services, such as cancer screenings and shots.

Order further tests, depending on your general health and medical history.

You do not pay a copayment for your "Welcome to Medicare" visit. The Part B deductible does not apply to the cost of the visit either.

After the visit, your provider will give you a personalized prevention plan or checklist with the screenings and preventive services recommended for you. These services are not part of the "Welcome to Medicare" visit. You may have to pay a co-payment for the recommended services when you get them. Your Part B deductible may also apply.

Learn more about what to expect at your Medicare wellness visit.

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The Annual Wellness Visit (AWV) is a yearly appointment with your primary care provider (PCP) to create or update a personalized prevention plan. This plan may help prevent illness based on your current health and risk factors. Keep in mind that the AWV is not a head-to-toe physical. Also, this service is similar to but separate from the one-time Welcome to Medicare preventive visit .

Eligibility

Medicare Part B covers the Annual Wellness Visit if:

• You have had Part B for over 12 months
• And, you have not received an AWV in the past 12 months

Additionally, you cannot receive your AWV within the same year as your Welcome to Medicare preventive visit.

Covered services

During your first Annual Wellness Visit, your PCP will develop your personalized prevention plan. Your PCP may also:

• Check your height, weight, blood pressure, and other routine measurements
• This may include a questionnaire that you complete before or during the visit. The questionnaire asks about your health status, injury risks, behavioral risks, and urgent health needs.
• This includes screening for hearing impairments and your risk of falling.
• Your doctor must also assess your ability to perform activities of daily living (such as bathing and dressing), and your level of safety at home.
• Learn about your medical and family history
• Medications include prescription medications, as well as vitamins and supplements you may take
• Your PCP should keep in mind your health status, screening history, and eligibility for age-appropriate, Medicare-covered preventive services
• Medicare does not require that doctors use a test to screen you. Instead, doctors are asked to rely on their observations and/or on reports by you and others.
• Screen for depression
• Health education and preventive counseling may relate to weight loss, physical activity, smoking cessation, fall prevention, nutrition, and more.

AWVs after your first visit may be different. At subsequent AWVs, your doctor should:

• Check your weight and blood pressure
• Update the health risk assessment you completed
• Update your medical and family history
• Update your list of current medical providers and suppliers
• Update your written screening schedule
• Screen for cognitive issues
• Provide health advice and referrals to health education and/or preventive counseling services

If you qualify, Original Medicare covers the Annual Wellness 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 AWVs 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 AWV, 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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What to Expect at Your Annual Wellness Visit

Once a year, you make an appointment with your primary care physician to make sure your health is in good working order and detect potential concerns early, before symptoms are noticeable.

To schedule your annual wellness or follow-up office visit with a provider in Primary Care, please visit here or login to Connect .

Most insurance plans cover your annual wellness exam — no copay required. However, you may find the actual components of a wellness visit a bit confusing.

Review the FAQs below to learn what to expect during your next annual wellness visit.

Frequently Asked Questions

What is included in a wellness visit.

Your annual wellness visit includes the following:

• A review of your medical and surgical history
• Screenings - we generally follow screening recommendations of the USPSTF
• Blood tests
• Immunizations - we follow the vaccine schedules published by the CDC
• A physical exam
• Counseling to prevent future health problems 

How should I prepare for my visit?

Please check in via Connect up to 5 days before your visit to make sure we have your most up-to-date information, including your medications, medical history and insurance. You will be able to update these, along with your preferred pharmacy. You can also review and update your responses to your health questionnaire.

Please fast for at least 4 hours prior to your visit. You may drink water or black coffee, and take your maintenance medications.  Pediatric and Gynecology patients should not fast.

On the day of your appointment, please arrive on time and bring your insurance card and ID.

What if I need to ask my doctor about a specific medical issue?

Specific issues are considered part of a follow-up or “sick” visit. These aspects of your visit will be billed to your insurance, and you may be responsible for copayments, coinsurance or deductible payments, based on the terms of your policy.

If you would like to address non-routine concerns during your wellness visit, you can let your doctor know about these issues when you schedule your appointment. Depending on their complexity, the questions may need to be dealt with at a later time.

What does a follow-up or “sick” visit include?

• Treatment of a chronic condition such as diabetes, asthma or high blood pressure
• Any new problems or complaints
• Your need for new medications or tests
• Referrals to a specialist
• Additional treatment options

What is a Medicare annual wellness visit and what does it include?

The Medicare annual wellness visit, covered by Medicare, allows your health-care provider to conduct a health risk assessment and propose screenings and prevention strategies. As well, your provider will make sure all your immunizations, cancer screenings and other screenings are discussed and scheduled.

Your Medicare wellness visit does not include a detailed physical exam or management of chronic or new medical problems . Your physician may be able to perform a complete physical and address new or existing medical issues during your Medicare annual wellness visit, but you could incur additional charges.

What to expect during your Medicare annual wellness visit

At your Medicare annual wellness visit, your health care provider will:

• Review your blood pressure, heart rate, height, weight and body mass index (BMI).
• Review your current health problems, as well as your medical, surgical, family and social histories.
• Review your current medications.
• Conduct a health risk assessment.
• Provide nutrition counseling.
• Discuss an exercise plan to fit your lifestyle.
• Discuss smoking cessation and arrange for counseling, if needed.
• Discuss fall prevention.
• Discuss advance care planning.
• Discuss preventive screenings recommended by evidence-based practice guidelines that are indicated for you based upon your age, risk factors and family history

How to prepare for your Medicare wellness visit

Bring these items to your visit:

• Immunization records
• A list of current prescribed medicines, supplements and over-the-counter medications
• A list of your patient care team—any specialists you see for various types of care
• Be prepared to review your family medical history.

Can I combine a Medicare or non-Medicare wellness visit with a follow up visit?

Combining a wellness visit with a follow-up office visit will save you time by eliminating an extra appointment, but doing so may affect your costs. Additional concerns beyond a wellness visit may be billed to your insurance, which can  result in unplanned out-of-pocket costs to you. For these reasons, Weill Cornell Primary Care recommends that you schedule your annual wellness visit and any follow-up or sick office visits separately.

What are the most important points I need to keep in mind?

• Review your insurance plan’s summary of benefits before your appointment to understand what your insurance company will or will not cover.
• When scheduling a wellness visit, clearly state that you would like to make an appointment for your annual wellness or preventive care exam. That will help the practice prepare for your visit and bill your insurance company appropriately.
• When you speak with your doctor or other practitioner, let them know you are there for a wellness exam. Or, if you need to discuss a specific concern that may require treatment, make sure to bring their attention to any non-routine concerns at the start of your appointment.

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At first a preventive visit and office visit may seem similar, but there is a difference. Knowing which to schedule can help ease any confusion.

You schedule preventive visits which are annual physicals, well child exams and wellness exams to help prevent or detect any health concerns. This is also known as your annual wellness exam or annual health maintenance exam. Confusion comes when at your annual checkup you want to discuss or receive treatment for a new or existing condition that requires action. This is where a preventive visit can become an office visit and your bill can be impacted.

You schedule an office visit, or problem-related service, for problem focused care, meaning you notice symptoms and want to talk with your provider. In your preventive visit if a problem is addressed and needs to be treated, your provider’s office is required to bill as a separate office visit, due to action for treatment needed.

What is a preventive visit?

• Complete physical exam (annual health maintenance exam)
• Blood pressure, blood glucose and cholesterol screening tests
• Pelvic exams, pap smear
• Prostate and colorectal cancer screenings
• Sexually transmitted infection testing
• Thorough review of medical history, general health and well-being
• Vaccination review and update
• Developmental screenings
• Evaluation of future risks

What is an office visit?

• Diagnosing and monitoring specific medical conditions
• Addressing medical concerns and treatment plans
• Post hospitalization discharge care
• Medication refills
• Specialist referrals
• Testing/lab results
• Addressing new or worsening symptoms
• Depending on benefits an office visit can result in additional costs

Before scheduling an appointment state clearly whether this will be a wellness exam or if this appointment will be to discuss and treat new health concerns or symptoms. If a wellness exam is spent on specific or new health issues and treated it will no longer be considered a preventive visit, and it will be billed as an office visit.

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In the exam room, the distinction between one type of visit and another isn't always clear. It's important to know when — and how — you can bill for both .

BETSY NICOLETTI, MS, CPC, AND VINITA MAGOON, DO, JD, MBA, MPH, CMQ

Fam Pract Manag. 2022;29(1):15-20

Author disclosures: no relevant financial relationships.

In family medicine, it's common for a medical problem to crop up during a routine preventive visit, or for a preventive service to crop up during a problem-oriented visit. For example, let's say you're finishing up a Medicare annual wellness visit when the patient lifts his shirt and says, “Oh yeah, I'd also like you to look at this rash,” which results in a prescription. Or, at a follow-up visit for a patient's chronic condition, you notice he is overdue for a flu shot and colorectal screening, so you perform a preventive visit too.

From a coding perspective, there is a bright line between a preventive medicine visit and a problem-oriented visit. One is for promoting health and wellness, and the other is for addressing an acute or chronic medical problem. But in the exam room, the distinction isn't always clear. The question for family physicians is this: When does the work in the exam room warrant billing for two distinct services?

The answer lies in knowing the requirements for various preventive medicine and Medicare wellness visits, knowing when you've done enough beyond those requirements to also bill for a separate E/M service, and knowing how to document and code it all. The good news is the 2021 E/M coding changes made it easier than it used to be.

When physicians and other clinicians address a medical problem during a preventive or wellness visit, they can often bill for both services.

Knowing the core components of preventive or wellness visits can help physicians recognize when they have done enough work beyond those requirements to bill for a separate evaluation and management service.

Because preventive and wellness visits come with no cost sharing, it's best practice to explain to patients that a separate service performed during the same visit may result in a charge to them.

PREVENTIVE MEDICINE VISITS

Preventive medicine visits (CPT codes 99381-99397) are for patients covered by commercial insurance, Medicaid plans, and some Medicare Advantage plans. Patients value these visits because they are not subject to co-pays and deductibles. After age two, one preventive visit is covered annually.

According to CPT, preventive medicine visits are “comprehensive preventive medicine evaluation and management services of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures.”

Codes 99381-99387 are for new patients and 99391-99397 are for established patients. Both are further broken down by age group. The extent of the exam, the content of the counseling and anticipatory guidance, and the recommended screenings and immunizations vary depending on the patient's age and gender. “Comprehensive” in the CPT definition is not synonymous with the comprehensive exam required in other E/M services. This is a common misconception among physicians and patients alike.

CPT states that if a new or existing problem is assessed and managed at the time of the preventive visit, the physician should also bill a problem-oriented visit (an office visit) on the day of the preventive care. But insignificant problems that do not require extra work should not be billed as office visits. If a patient comes in for a preventive visit and the clinician also looks at a rash or notices the patient's blood pressure is elevated, these observations alone are not enough to bill a problem-oriented E/M visit. There must be some medical decision making (MDM) that occurs, such as prescribing a topical treatment for the rash or choosing not to prescribe a medication for the high blood pressure and instead suggesting the patient change his diet.

Once you've documented your MDM, you can bill an E/M visit using codes 99202-99215 with the preventive medicine visit code. Make sure to add modifier 25 to the E/M code to signal to the payer that two distinct visits were done on the same day.

For more details on when to bill both visits, how to level the E/M portion, and what to include in your documentation, see “ One visit or two? ”

ONE VISIT OR TWO?

Medicare wellness visits.

Original (traditional) Medicare does not cover CPT codes 99381-99397, because Medicare has its own wellness visits with their own “G” codes and requirements. As mentioned, some Medicare Advantage plans do cover the preventive medicine CPT codes in addition to Medicare wellness visits. However, a Medicare wellness visit and a preventive visit should not be billed on the same date of service. Medicare developed the Initial Preventive Physical Examination (IPPE, also known as the “Welcome to Medicare” visit) (G0402) and initial and subsequent annual wellness visits (G0438 and G0439) to encourage Medicare patients to receive screenings and preventive care, and to work with their physicians to develop a personalized prevention plan. 1 The requirements are slightly different for the three codes, but in general they require collecting or updating medical, family, and social history; screening for depression; evaluating the patient's ability to perform activities of daily living; assessing the patient's safety at home; recording vital signs; asking about opioid and substance use; and providing guidance about preventive services and a personalized prevention plan (for more details, see the table in “ Medicare 101: Navigating the Rules for Coverage and Benefits in Clinical Practice ”). Similar to CPT's preventive medicine visits, Medicare wellness visits do not require a full head-to-toe physical exam.

The assessment and management of acute or chronic problems are not components of the IPPE or annual wellness visits. When that service is medically necessary during a Medicare wellness visit, the physician can also bill for a problem-oriented E/M office visit on the same day, again using the appropriate CPT code (99202-99215) with modifier 25.

SELECTING THE LEVEL OF SERVICE FOR THE E/M CODE

Hopefully you're now familiar with the E/M coding rules that changed in 2021. 2 Performing a problem-oriented E/M service on the same date as a wellness visit adds a layer of complexity when it comes to choosing the level of service for the E/M code. But, as mentioned, the new rules actually make it easier than it was before.

When selecting a code (99202-99215) using the new E/M guidelines for office and outpatient services, physicians may use either total time on the date of the visit or MDM. History and exam are no longer necessary to select the level of service (though they should still be documented to provide the best care). This makes it easier to select a level of service for the problem-oriented visit when it's combined with a wellness or preventive visit because there are fewer overlapping components when coding based on MDM. The E/M service is your assessment and management of an acute or chronic condition, which is not required in either CPT preventive services or Medicare wellness visits.

It's trickier to code the E/M service based on time because you must make sure to only count the time spent managing the problems, not the time spent on the preventive or wellness service. The February 2021 CPT Assistant newsletter was particularly clear on this, stating “if time is used for selection of a level of the office/outpatient E/M code, the time spent on the preventive service cannot be counted toward the time of the work of the problem assessment because time spent performing a service cannot be counted twice. The code for the problem-assessment portion of the encounter will likely be selected based on MDM.” 3 It might make sense to consider MDM-based coding as the best practice when combining E/M visits with wellness visits.

A problem-oriented visit includes the history of the problem and any symptoms or complaints related to it. It may or may not include a physical exam or data review (e.g., notes reviewed, tests ordered, tests reviewed, or independent historian). It includes the evaluation and management of a problem or condition. When these components are documented in addition to the preventive visit, add a problem-oriented visit code. For more on which components are required for which visits, see “ How to credit combined visits .”

Let's look at some examples of when it would be appropriate to bill for a problem-oriented E/M code (CPT 99202-99215) along with a preventive or wellness visit.

Patient 1: A 70-year-old male, established patient with a history of diabetes and hyperlipidemia comes in for a Medicare annual wellness visit. All required components of the wellness visit are completed. The patient then asks for a refill of his diabetes medication. The physician asks the patient if he is taking his medication as prescribed and following the diet recommendations discussed during the last visit. The physician also performs a focused physical exam, discusses medication management for diabetes and hyperlipidemia, and orders maintenance labs. The physician documents her significant review of the patient's problems, bills for the annual wellness visit with code G0439, and adds a 99214 E/M code because she addressed two stable chronic illnesses and performed prescription drug management. She adds modifier 25 to the E/M code.

Patient 2: A 32-year-old female, new patient comes in for a preventive medicine visit required by her employer. The physician completes all requirements for the preventive visit. During the history portion, the patient tells the physician that she has been having some knee pain exacerbated by running. The physician obtains additional history about the pain, examines her knee, tells her to reduce her running until the pain subsides, and gives her a handout on knee exercises. He also recommends she try a knee brace and follow up if the pain does not lessen with rest. The physician documents the extra work done to address the knee issue, then bills code 99385 for an initial preventive medicine visit for a patient age 18–39, along with E/M code 99203 because he addressed one acute, uncomplicated injury. He adds modifier 25 to the E/M code.

Patient 3: A 49-year-old female, established patient comes in for her annual preventive visit. The physician completes all requirements for the preventive visit. The patient then mentions she has been excessively tired recently and has been having trouble sleeping. The physician obtains a detailed history of the problems, does a thorough physical exam, and orders some labs (complete blood count and thyroid-stimulating hormone). The physician documents the extra work, then bills code 99396 for a periodic preventive medicine visit for a patient age 40–64 and E/M code 99213 for addressing two acute illnesses (fatigue and insomnia) and ordering two labs. The physician adds modifier 25 to the E/M code.

WORKFLOW TIPS

It's hard to plan for surprise problems that come up during a preventive or wellness visit. But your staff can help by asking patients up front if they have any other issues that need to be addressed. This step should occur when staff are scheduling or confirming patient visits, allowing you to block off more time if necessary.

Scheduling staff should also be aware that Medicare wellness visits have strict rules about how often they can be billed. They must be separated by at least 12 months from the previous wellness visit. Having staff check eligibility for Medicare wellness visits using the HIPAA Eligibility Transaction System can help you avoid denials. 4 The timeframes for CPT preventive visits are more forgiving; they can be performed once every plan year (usually a calendar year, but some plans vary).

Patients who know their preventive/wellness visit will be covered with no deductible or co-pay may mistakenly assume all services provided during that visit, including E/M, will be no cost to them. It is best to educate patients on the costs associated with a problem-oriented office visit and let them know that performing one with a preventive or wellness visit will result in the same co-pay they would incur if the problem-oriented visit was on a different day. Most patients will accept this, because getting both visits in the same trip is more convenient for them. Posting flyers in the exam rooms or waiting room about the difference between preventive/wellness visits and problem-oriented visits, and the costs associated with each, can also prevent patient dissatisfaction.

Physicians could ask these patients to return for the problem-oriented visit on another day, but if time allows for providing both services at the current visit, it is only fair and reasonable to do so. Knowing the rules for combined visits, and the convenience they offer patients, should give physicians the confidence to bill fully for their services.

The ABCs of the Initial Preventive Physical Examination. Medicare Learning Network. Accessed Nov. 15, 2021. https://www.mvphealthcare.com/wp-content/uploads/download-manager-files/CMS-ABC-Initial-Preventive-Physical-Examination-ICN006904-01-2015.pdf

Millette KW. Countdown to the E/M coding changes. Fam Pract Manag . 2020;27(5):29-36.

Evaluation and management (E/M) 2021; AMA CPT Assistant . 2021;2:7-8.

HIPAA Eligibility Transaction System (HETS). Centers for Medicare & Medicaid Services. Updated Oct. 25, 2021. Accessed Nov. 15, 2021. https://www.cms.gov/research-statistics-data-and-systems/cms-information-technology/hetshelp

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Preventive Services

Prep for hiv: prepare for potential medicare part b coverage.

On July 12, 2023, CMS proposed to transition coverage of Preexposure Prophylaxis (PrEP) using FDA-approved antiretroviral drugs (oral or injectable) to prevent HIV to Medicare Part B. Currently, HIV PrEP drugs may be covered under Medicare Part D.

It’s critical that your patients have uninterrupted access to their HIV PrEP drugs. We’re encouraging you to prepare your systems now so you’re able to immediately transition to Part B coverage if we release a final National Coverage Decision (NCD).

Review our fact sheet (PDF) and frequently asked questions (PDF) to learn more about how you can prepare for the possible upcoming coverage change, including information about enrollment, billing, claims processing, and coding.

Medicare covers many preventive services to keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can help keep your patients from getting certain diseases. Talk to your patients about which preventive services are right for them and how often they need them.

If you’re a person with Medicare, learn about all preventive services .

Learn more about billing for Medicare-covered preventive services:

• COVID-19 vaccine toolkit
• Hepatitis B shot
• Pneumococcal shot
• In-Home Vaccine Administration: Additional Payment
• Medicare Benefit Policy Manual – Chapter 15: Section 50.4.4.2 – Immunizations (PDF)
• Roster Billing: COVID-19, Flu, & Pneumococcal vaccines
• Skilled Nursing Facility: Billing Medicare for Respiratory Vaccines (PDF)
• Medicare Part D Vaccines (PDF)
• Annual wellness visits
• Initial preventive physical exam
• Medicare wellness visits educational tool
• Diabetes screening
• Diabetes Self-Management Training (DSMT)
• Medicare Diabetes Self-Management Training (PDF)
• Medicare Diabetes Prevention Program (MDPP)
• Pre-Diabetes Services: Referring Patients to the MDPP (PDF)
• Bone mass measurements
• Cardiovascular disease screening tests
• Cervical cancer screenings with Human Papillomavirus (HPV) tests
• Colorectal cancer screening tests
• Glaucoma screening
• Hepatitis B screening
• Hepatitis C screening
• HIV screening
• Lung cancer screening
• Mammography screening
• Pap tests screening
• Prolonged preventive services
• Prostate cancer screening
• Screening Pap Tests & Pelvic Exams (PDF)
• Screening pelvic exams, including clinical breast exam
• Sexually transmitted infection (STI) screening
• Ultrasound Abdominal Aortic Aneurysm (AAA) screening
• Alcohol misuse screenings & counseling
• Counseling to prevent tobacco use
• High intensity behavioral counseling to prevent STIs
• Intensive behavioral therapy for cardiovascular disease
• Intensive behavioral therapy for obesity
• Medical nutrition therapy
• Medicare & Mental Health Coverage (PDF)
• Depression screening
• Medicare Preventive Services  educational tool
• Medicare Claims Processing Manual, Chapter 18 – Preventive and Screening Services (PDF)

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Health benefits & coverage

Preventive health services, preventive services for all adults, women, and children.

• For all adults
• For children

Doctor Visits

Find and Access Preventive Services

Take Action

Preventive services include health care like screening tests, checkups, and vaccines. Unlike the care you get when you’re sick or managing a long-term condition, preventive care can help stop you from getting sick in the first place — or it can find health problems before they get worse, even before you have symptoms. 

Why do I need preventive care?

There are lots of great reasons to get preventive care. It can:

• Save your life. Screening tests and checkups can find health problems early, when they may be easier to treat. This includes serious diseases like cancer.
• Prevent disease . Some preventive services can keep health problems from developing. This includes vaccines and screenings for certain cancers, like cervical cancer.
• Help you save money . Finding and treating health problems early can help you avoid costly medical bills down the road. Plus, most insurance plans cover preventive services, and there are free or low-cost options if you don’t have insurance. 
• Offer peace of mind. Regular checkups are a chance for you to share concerns and ask questions about your health — and to get support from a doctor or other health care professional.

How to Get Preventive Care

Make an appointment with your doctor..

Talking with your doctor or nurse is a great first step to getting preventive care. They can tell you which screenings, vaccines, or other services you need — and answer any questions you may have. Together, you can make a plan to protect your health.

Looking for a new doctor or nurse? Use these tips to find the right fit .

Find free or low-cost preventive care.

Most health insurance plans cover preventive services at no cost to you — usually without a copay or deductible. 

But even if you don’t have health insurance, you can still get free or low-cost preventive care. Try these tips:

• Visit a community health center or clinic. Community health centers and clinics can offer affordable — or even free — preventive care. Find a health center near you . 
• Contact your local health department. Many health departments offer free health services, like flu vaccines, to people in the community. Your health department can also give advice on where to find additional free or low-cost health care services in your area. Use this interactive map to find your local health department.
• Look for volunteer clinics. Some communities offer free clinics run by volunteers for people who don’t have health insurance. Find a volunteer clinic near you.  
• Ask your local hospital about free screenings. Many hospitals offer free screening events. Contact your hospital’s customer service or community outreach department to learn what options are available.

If you’re getting health care through the Indian Health Service (IHS), use this tool to find preventive care near you. And if you’re a Veteran, you can get care at a VA location in your area. 

Look for free screening and testing programs for specific diseases.

There are also some free or low-cost programs to help you get screened or tested for specific diseases. For example:

• Screening for breast and cervical cancer: National Breast and Cervical Cancer Early Detection Program (NBCCEDP)
• Testing for HIV, STIs (sexually transmitted infections), and hepatitis: Get Tested search tool

Learn about insurance coverage for preventive services.

If you have private health insurance:.

Private health insurance means you’re getting your insurance through an employer or the Health Insurance Marketplace. Under the Affordable Care Act, private health insurance plans must cover many preventive services. Depending on your insurance plan and other factors like your age, you may be able to get these and other preventive services at no cost to you:

• Blood pressure , diabetes , and cholesterol tests
• Many cancer screenings, including mammograms and colonoscopies
• Counseling on topics like quitting smoking , losing weight , eating healthy , treating depression , and drinking less alcohol
• Vaccines to protect against diseases like the flu, whooping cough, measles, and meningitis
• Counseling, screening, and vaccines to help you have a healthy pregnancy
• Regular well-baby and well-child visits

Keep in mind that you may be charged a portion of the cost if a preventive service isn’t the main reason for your doctor’s visit or if you’re seeing an out-of-network provider. To avoid unexpected medical bills, ask your doctor before your appointment what services will be covered — or check with your insurance company.

To learn more, check out these resources about: 

• Free preventive care covered by the Affordable Care Act
• How the Affordable Care Act protects you  
• Understanding your health insurance and how to use it [PDF - 698 KB]  

If you have Medicaid:

Medicaid covers certain preventive services at no cost, like vaccines and recommended screenings and tests. It also covers counseling to help you manage long-term health conditions and support healthy changes, like quitting smoking. You can:

• Find out more about getting preventive care through Medicaid
• Contact your state’s Medicaid agency for detailed information

If you have Medicare:

Medicare also covers certain preventive services at no cost. To learn about Medicare and preventive care:

• Browse this list of covered services
• Use this tool to see what Medicare covers

If you’re uninsured, explore options for getting health insurance.

There are different options for getting health insurance coverage — and it may be more affordable than you think. To get started, you can:

• Check to see if you’re eligible for Medicaid. The Medicaid program provides health insurance for families with low incomes, pregnant people, people with disabilities, and people in certain other groups. Find Medicaid coverage in your state.   
• Enroll your children in CHIP. The Children’s Health Insurance Program (CHIP) covers children in families that earn too much money to qualify for Medicaid but not enough to afford private health insurance. Learn more about CHIP.
• Explore the Health Insurance Marketplace. The Marketplace offers health insurance plans for anyone who needs it. How much you’ll pay for coverage depends on how much money your family earns. Read this quick guide to Marketplace coverage or find local help.

Content last updated June 7, 2024

Reviewer Information

This information on preventive services was adapted from materials from the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services.

Reviewed by: U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion Review Team.

You may also be interested in:

Get Screened

Take Charge of Your Health Care

Get Your Medicare Wellness Visit Every Year

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Martin Wellness Center

Exercise is a key component of a healthy lifestyle..

Exercise in our welcoming health and fitness center.  The Martin Wellness Center is home to many of Gritman’s exercise programs for all ages and abilities. At the Martin Wellness Center, our certified, highly trained staff can help you meet your wellness goals. We offer a variety of classes, both on the floor and in our therapy pool, geared toward helping you achieve optimum health and wellness. The center also offers exercise equipment for your use.

All services offered at the wellness center are self-pay. Your insurance will not be billed.

Registration

To use the Martin Wellness Center, you must return the following:

• A completed application
• An informed consent and release of liability form
• A signed waiver from your physician

The waiver form can be sent from the Martin Wellness Center staff to your physician’s office at your request. Ask our staff for assistance. We are happy to help.

Exercise Programs

The Ron & Janie Nirk Therapy Pool is ideal for non-weight-bearing exercise, remaining at a consistent 90 degrees Fahrenheit. Patrons can use the pool during independent swim times during our hours of operation. The center also offers a therapy spa for a post-workout soak.

Medical Clearance from your PCP is required to use the facility. Martin Wellness Center’s pool is a therapy pool and therefore not safe for recreational use by children. All children must be referred by a physician and accompanied by an adult for therapeutic purposes only. Diapers designed for pool use are required for those who need them.

510 W. Palouse River Dr. Moscow, ID 83843

Hours Monday-Friday 6:15 a.m. to 6:30 p.m.

Contact Phone: 208-883-9605 Fax: 208-883-9617

Available Classes

• Movement Matters Class: Circuit class aimed to develop strength, balance and mobility. Use exercise machines and balance equipment, as well as guided workouts.
• PE for PD: Class designed for Parkinson’s Patients, please call to find out more.
• PiYo: Instructor lead gentle Pilates- and Yoga-based exercise class. Works on strength, mobility, and balance.
• Personal Training: Contact the Wellness Center to schedule a time that works with our Personal Trainer.

Your safety is important to us. All Martin Wellness Center instructors are certified in BLS/CPR, and the majority have degrees in exercise science or kinesiology.

Gym Schedule and Rates

Private Events

The Wellness Center’s meeting space is available for community members to rent. Contact us if you are interested in renting space for an event. We are proud to be an integral part of our community’s health and look forward to seeing you here!

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• Donate Monthly Pool Membership 3x/week ($65)
• Donate Any Amount

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Health spas and health resorts - a little time out

If you want to get away from it all and relax, Germany is the place for you: Over 350 health spas and resorts are just waiting to pamper you with sensational feel-good experiences in water, in the mountains or in the midst of green meadows and forests. We present a selection.

Here you can find all members of the „Deutsche Heilbäderverband“ (German Spas Association).

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Why preventive medicine is key to pet health

• Sarah Boudreau

13 Jun 2024

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Preventive care is the foundation of good health. However, it's also easy for pet owners to dismiss preventive care as an unnecessary expense. Most people aren’t looking for one more errand to run, but that annual wellness exam is well worth the time and money.

Dogs and cats age faster than humans—for example, for an adult dog, each "human year" is approximately 4-5 "dog years." That means that a lot can change in a year! Wellness exams and other forms of preventive care make sure your pet stays healthy. 

Prevention can save you money

Regular wellness visits, vaccinations, dental care, and other routine appointments mean you can catch any problem early. For most diseases, treatment is cheaper and easier when caught early, so catching a disease before symptoms show can save money down the road.

“This is especially true for dental care," said Mark Freeman , clinical associate professor of community practice at the Virginia-Maryland College of Veterinary Medicine . “A routine dental cleaning is far less invasive and expensive than a dental that is years overdue, which often involves extracting diseased teeth and significantly greater expense.”

A routine blood or urine test could identify a disease in its early stages, giving you and your veterinarian the opportunity to intercede years before the disease has progressed to the point of costly hospitalization.

Pet illness isn’t always obvious 

Pets don’t always let on when they’re feeling sick. Cats are especially well-known for hiding illness. 

Why do pets hide their illness? The leading theory is that our furry friends hide their pain because in the wild, signs of pain or illness could make them a target for predators. 

It’s not always obvious when your pet isn’t feeling well, but in an exam, your veterinarian can better identify any health problems your pet experiences.

Another advantage of bringing your pet in for regular checkups is that your veterinarian can record their baseline values. If one of those values (weight, for example) shows a remarkable change, it could be a sign of a bigger health problem.  

Stay up to date

Vaccinations are an important part of preventive medicine. By keeping up to date on veterinarian-recommended vaccines, you can stop disease in its tracks. 

Vaccines contain either partial or weakened versions of viruses and/or bacteria. In response to those antigens, your pet’s immune system creates antibodies. Those antibodies allow your pet’s body to fight off the virus or bacteria if it is exposed to it again. However, over time, the effect of some vaccines grows weaker — that's why booster shots are necessary. 

Prevention is key 

Do you have your pet’s next wellness exam scheduled? Remember, preventive care catches disease early, making your pet healthier and your wallet fuller.

Andrew Mann

540-231-9005

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