In a Medicare wellness exam, healthcare providers typically ask about your medical history, medications, and any current health concerns. They may also inquire about your lifestyle, including exercise and diet, to assess your overall well-being. Having a Medicare Preventive Checklist Fillable Form on hand can streamline this process, allowing you to provide accurate information and engage more fully in your health discussions.

During a Medicare wellness exam, it's essential to remember the words 'Prevent, Detect, and Treat.' These words summarize the goals of the exam, which focuses on preventing illness, detecting potential health issues early, and treating them effectively. Utilizing a Medicare Preventive Checklist Fillable Form can help you track important health metrics and ensure you discuss relevant topics with your healthcare provider.

INITIAL ANNUAL WELLNESS VISIT (G0438) This visit is offered to patients only once in their lifetime. They are eligible within 11 calendar months after their IPPE. The reimbursement is around $173.

Three Unique Annual Wellness Visit Codes: G0402, G0438, and G0439. Medicare preventive wellness visits fall into three categories; the "Welcome to Medicare" visit, also known as the Initial Preventive Physical Exam (IPPE); the initial annual wellness visit, and the subsequent annual wellness visits.

You would bill Healthcare Common Procedure Coding System (HCPCS) Level II code G0402, “Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment” for the service, which has an average reimbursement of $168.68.

You can only bill G0438 or G0439 once in a 12-month period. G0438 is for the first AWV and G0439 is for subsequent AWVs.

G0439 Annual Wellness Visit, Subsequent (AWV) Annual Wellness Visits can be for either new or established patients as the code does not differentiate. The initial AWV, G0438, is performed on patients that have been enrolled with Medicare for more than one year.

Coding and Billing a Medicare AWV Medicare will pay a physician for an AWV service and a medically necessary service, e.g. a mid-level established office visit, Current Procedural Terminology (CPT) code 99213, furnished during a single beneficiary encounter.

Preventive visit codes 99381-99397 include “counseling/anticipatory guidance/risk factor reduction interventions,” ing to CPT. However, when such counseling is provided as part of a separate problem-oriented encounter, it may be billed using preventive medicine codes 99401-99409.