Annual Wellness Visit in SNF or Nursing Facility

katfitzpat

Networker
Messages
27
Location
Santa Rosa, CA
Best answers
0
Help!

I am looking for Medicare guidelines for the possibility of providing Annual Wellness Visits (G0438 / G0439) to patients who are residing in a SNF (POS 31) or Nursing Facility (POS 32)

Can the wellness service be provided in these facilities with successful reimbursement for mid-level providers?

If I recall, the POS 31 and 32 do not reimburse theses services however now I cannot locate any specific guideline from Medicare or CWF to back up my information to the inquiring parties.

I am spinning my wheels trying to locate any guidelines or formal notice in MLN related to these services and POS.
I am in Northern California and have looked in MLN, CWF, CMS, and Noridian Jurisdiction E Part B.

Thank you in advance for any information anyone can provide for me!
Kathy Fitzpatrick, CPC
Clinical Review Specialist
 

mmullnix

Networker
Messages
32
Location
Rohnert Park, CA
Best answers
0
AWV for SNF patients

Although an annual wellness code is excluded from consolidated billing for patients in a SNF during part A services, I still have a question as to whether the risk adjusted codes will be credited. Both CMS and a Medicare Advantage plan state that these risk adjusted codes are not counted due to not being considered as reliable as other preferred sources. Can anyone confirm or provide additional information on this subject?
 
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