An Annual Wellness Visit is a yearly clinician guided exam in which a patient's physical, mental, and emotional health is examined and documented. An AWV appointment focuses on identifying the patient’s health risk along with providing appropriate counseling in order to promote a healthy lifestyle. This might include but is not limited to, recommending reading material, educational programs, or referrals that are particular to the patient’s risk factors. An AWV appointment is covered under Medicare part B as long the patient has not had an annual wellness visit or Welcome to Medicare Visit (IPPE) within the last 12 months. 

Different Types of AWV's:

Welcome to Medicare (IPPE)

The Initial Preventative Physical Examination (IPPE) or better known as the "Welcome to Medicare Visit" is only available to the patient within the first 12 months after enrolling in Medicare. Once a patient's initial 12 months pass they will no longer be eligible to receive this benefit. However, they will be eligible for an initial annual wellness visit.
Billing Code: G0402
The National Average Reimbursement: $168.89

Initial Annual Wellness Visit (IAWV)

The Initial Annual Wellness Visit can only be completed once by a medicare patient; however it yields yearly benefits and there is no Co-pay. This particular exam is is more comprehensive than the IPPE assessment, so the reimbursement is higher. If a patient has participated in the IPPE, 12 months must pass before they become eligible for the Initial Annual Wellness Visit. However, if a patient has not used their IPPE within the first year of being a Medicare customer they become eligible for their Initial Annual Wellness Visit.
Billing Code: G0438
The National Average Reimbursement: $174.28

Subsequent Annual Wellness Visit

The Subsequent Annual Wellness Visit is only offered to Medicare patients 12 months after they have completed their Initial Annual Wellness Visit.
Billing Code: G0439
The National Average Reimbursement: $117.86

Actions Involved in a Welcome to Medicare Visit:

  • Review patient medical and social history (e.i. medical history, current medications, diet, family history etc)

  • Review patient risk factors

  • Routine Measurements such as blood pressure, weight, height, etc.

  • Review patient's functional ability and safety level

  • Discuss end of life planning

  • Provide appropriate referrals, educational programs and counseling based on review of patient.

  • Provide brief plan for referrals, educational programs and counseling in which you suggest to promote the patients health 

Actions Involved in an Initial Annual Wellness Visit:

  • Perform a Health Risk Assessment Questionnaire (HRA)

  • Establish patient's medical and family history

  • Document patients current providers and suppliers 

  • Routine Measurements such as blood pressure, weight, height, etc.

  • Perform a patient Cognitive Assessment

  • Review patients risk for depression which includes previous experiences with mood disorders

  • Document patients functional abilities and safety level

  • Develop screening schedule for patient

  • Establish a list of risk factors and conditions along with possible treatment options

  • Provide patient with individualized health advice along with recommended referrals to educational health programs 

  • Discuss future advanced care planning services (at the patient's discretion)

Actions Involved in a Subsequent Annual Wellness Visit:

  • Review of the HRA and update appropriately 

  • Update patient's medical and family history

  • Update current providers and suppliers

  • Take new routine measurements (blood sugar, weight, height)

  • Perform a patient Cognitive Assessment

  • Update the patient's written screening schedule

  • Update patient list of risk factors and conditions along with possible treatment options

  • Update patient with individualized health advice along with recommended referrals to educational health programs 

  • Discuss future advanced care planning services (at the patient's discretion)

What ThoroughCare Does for you:

  • Provides an organized HRA Assessment (patient has the ability to take this assessment from home or in office)

  • Allows you to properly document patient medical/ family history along with providers and suppliers of medical care

  • Supplies paperless documentation of routine measurements (office tests)

  • Provides Cognitive Assessment (Mini-Cog) to detect any cognitive impairment

  • Review-able Assessment for Risk generated from patient's answers on their HRA.

  • Supplies PPPS / Counseling / Referral tools to provide the patient with necessary means to improve their health

  • Optional Advanced care planning for the patient's future

  • Printable report of patient's Annual Wellness Visit

Just so you Know:

  • Though there may be some similarities an AWV is not a yearly physical.

  • Medicare does waive the copay or coinsurance  for AWV programs.

  • An AWV does not include clinical laboratory tests however you are able to make the appropriate referrals for any recommended tests as part of the AWV.


Did this answer your question?