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Primary Care - Annual Wellness Visits

  1. Question Primary Care - Annual Wellness Visits
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    Hello all! Would someone mind sharing input on their experiences of additional services that can be billed (and be paid for) the same day as the annual wellness visits? With Medicare, I know that transitional care services can be billed separately if performed. One of our providers has tried billing depression screening, alcohol screening and tobacco counseling separate to no avail. Any suggestions or recommendations on services that can be carved out, billed and actually paid?

    Thank you!

  2. #2
    Good morning,

    As a rule of thumb for AWV/IPPEs, most extra preventive services (depression, alcohol screen, tobacco cessation) can't be billed with G0402 (IPPE) and G0438 (Initial AWV), however might be able to bill with G0439 (Subsequent AWV).

    Advanced Care Planning might be an option, however in order to make this part of the preventive benefit, amend modifier 33 to remove any copay for the patient (as appropriate). ACPs can be billed with G0438 and G0439 if furnished correctly and time is spent and documented ethically as well.

    Here is my local MAC explaining how they work in my area:

    Hope that helps!
    Last edited by Pathos; 11-05-2018 at 05:25 PM. Reason: Updated ACP guidelines
    "When you have exhausted all possibilities, remember this: You haven't!"
    -Thomas Edison

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