Annual Wellness Visit (AWV) - Medicare

 HCPCS/CPT Codes

• G0438 – Annual wellness visit; includes a personalized prevention plan of service (PPPS), initial visit
• G0439 – Annual wellness visit, includes a personalized prevention plan of service (PPPS), subsequent visit

Who Is Covered

All Medicare beneficiaries who are both,

• Not within 12 months after the effective date of their first Medicare Part B coverage period
• Have not received an Initial Preventive Physical Examination (IPPE) or AWV within the past 12 months

Frequently Used ICD

• Z00.00 - Encounter for general adult medical examination without abnormal findings
• Z00.01 - Encounter for general adult medical examination with abnormal findings
• Z00.121 - Encounter for routine child health examination with abnormal findings
• Z00.129 - Encounter for routine child health examination without abnormal findings

Frequency

• Once in a lifetime for G0438 (first AWV)
• Annually for G0439 (subsequent AWV)

Medicare Beneficiary Pays

• Co-payment/Coinsurance waived
• Deductible waived