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Clear IPPE Billing Confusion With Straight Answers From CMS

Published on Mon May 14, 2012

Start with G0402 and confirm details from there.

The initial preventive physical exam (IPPE) is an important service for every family physician's office, so be sure you're coding correctly. Learn the criteria IPPE visits must meet and when to use G0402, straight from a recent CMS National Provider Call.

Understand the IPPE Basics

"The IPPE is a one-time visit and is covered for beneficiaries within the first 12 months of Medicare Part B enrollment," says Jamie Hermansen, a health insurance specialist with CMS's Office of Clinical Standards and Quality/Coverage and Analysis Group. "The IPPE is covered by Medicare Part B."

A variety of professionals can furnish the IPPE, including: Physician Physician assistant Nurse practitioner Clinical nurse specialist. Important: The IPPE is a dedicated preventive visit, not an exam addressing specific problems.

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