You're correct...It would be the initial.
As a result of the ACA, effective January 1, 2011, Medicare will pay for an AWV for a beneficiary who is no longer within 12 months after the effective date of his/her first Medicare Part B coverage period, and he/she has not received either an IPPE or an AWV providing PPPS within the past 12 months. Medicare pays for only one first AWV (HCPCS G0438), per beneficiary per lifetime, and all subsequent wellness visits must be billed as a subsequent AWV (HCPCS G0439).
Beneficiaries in their first 12 months of Part B coverage will continue to be eligible for only the IPPE (see 188.8.131.52.A.1).
I found one template. You could always modify it to your physicians preferences. The only area I didn't like was the depression questionnaire.
I prefer the Beck's questionnaire...
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