Englewood Health Physician Network, Quality and Population Health

Quality Tip: Medicare Annual Wellness Visit

  • WHO: Traditional Medicare patients 65+
  • WHAT: Type of office visit
  • WHERE: PCP office
  • WHEN: Annually
  • WHY: It drives attribution and captures preventative measures to keep our patients healthy. It is also a covered service by Medicare and is therefore FREE to the patient.

Tips

  1. Medical Assistants and Care Coordinators can complete most of the visit, providers have more time with the patient!
  2. A wellness visit is the perfect time to address healthy habits such as diet and exercise especially in those patients whose BMI is above the normal range.
  3. Annual Wellness Visits are a great time to review and update the problem list for accuracy

BILLING CONSIDERATIONS:

Annual wellness visits use following codes:

  • G0402 – Welcome to Medicare Visit
  • G0438 – Initial Annual Wellness Visit
  • G0439 – Subsequent Annual Wellness Visit

Additional E&M code may be billed with modifier if provider performs a significant, separately identifiable, medically necessary evaluation and management code. Use codes 99212-99215, with modifier 25.