What is the code for welcome to Medicare wellness visit?
Asked by: Kavon Grady | Last update: January 16, 2026Score: 4.4/5 (59 votes)
What is the CPT code for welcome to Medicare wellness visit?
Billable for the first AWV only. Patient is eligible after the first 12 months of Medicare coverage. For services within the first 12 months, conduct the Initial Preventive Physical Exam (IPPE), also referred to as the Welcome to Medicare Visit (G0402).
What is the ICD-10 code for Medicare Wellness Visit?
An initial Annual Wellness Visit code is documented using G0438, subsequent Annual Wellness Visits are documented using code G0439. The Annual Routine Physical Exam allows members to seek a separate visit with their physician to discuss general health questions/issues without presenting a specific chief complaint.
What is G0402 welcome to Medicare?
G0402 CPT code description
Commonly referred to as the “welcome to Medicare visit,” it is considered a once in a lifetime assessment and after the initial eligibility period, the patient cannot receive an Initial Preventive Physical Examination. It is also dependent on the health risk assessment.
What is the difference between G0438 and G0439?
G0438 is for the first AWV, and G0439 is for subsequent AWVs. Don't bill G0438 or G0439 within 12 months of a previous G0402 (IPPE) billing for the same patient.
What are Medicare's Rules and Requirements for Annual Wellness Visits (AWV)?
What are the three types of Medicare wellness visits?
- Initial Preventive Physical Exam (IPPE)
- Initial Annual Wellness Visit (AWV)
- Subsequent AWVs.
What is G0463?
Hospital outpatient clinic visit for assessment and management of a patient.
How to code an annual wellness visit?
- G0402: This code applies to the Welcome to Medicare visit — also referred to as an Initial Preventive Physical Exam (IPPE). ...
- G0438: After 12 months of being enrolled in Medicare, a patient becomes eligible for their initial Annual Wellness Visit.
What is the difference between G0402 and G0403?
G0402 – IPPE is a face to face visit. Service is limited to a new beneficiary during the first 12 months of Medicare enrollment. G0403 – Electrocardiogram (ECG) performed as a screening for the IPPE (with interpretation and report)
Does Medicare pay for an annual wellness visit?
AWVs are fully covered by Medicare. Once a patient has been enrolled in Medicare Part B for over a year, they are eligible to receive an AWV once every twelve months. If they've been enrolled in Medicare for less than a year, they can receive a “Welcome to Medicare” visit instead.
What is a welcome to a Medicare visit?
The Welcome to Medicare preventive visit is a one-time appointment you can choose to receive when you are new to Medicare. The aim of the visit is to promote general health and help prevent diseases. Medicare Part B covers your one-time Welcome to Medicare preventive visit.
What are the three words to remember for a Medicare wellness exam?
Word recollection (Banana, Sunrise, Chair) Have patient repeat the 3 words, tell them to remember them.
What is the difference between a physical and an annual wellness visit?
While a physical includes a full examination and a wellness evaluation, an Annual Wellness Visits focuses solely on a patient's answers to a health risk assessment. It does not typically include any lab work or tests requiring physical contact.
How often can I have a Medicare wellness visit?
What about cost? With Medicare Part B, you can get a wellness visit once a year at no cost to you.
What is CPT code G0404?
HCPCS code G0404 for Electrocardiogram, routine ECG with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination as maintained by CMS falls under Initial Services for Medicare Enrollment .
What diagnosis should be used with G0444?
Annual Depression Screening: HCPCS Code G0444.
What is the CPT code for welcome to Medicare visit?
A - Medicare AWVs consist of three specific visit types statutorily covered by Medicare with no co-pay or deductible. They are the IPPE (the “Welcome to Medicare” visit, G0402), the initial AWV (G0438), and the subsequent AWV (G0439). These visits do not require a comprehensive physical exam.
What is not covered in a Medicare annual wellness visit?
Annual Wellness Visits do not include: A physical exam. Diagnosing of new conditions. Treatment of existing or new conditions.
What HCPCS code would be used to report an initial annual wellness visit?
HCPCS code G0438 (Annual wellness visit; includes a personalized prevention plan of service (PPS), initial visit) is a "one time" allowed Medicare benefit per beneficiary.
What is the difference between G0403 and G0405?
G0403 – Electrocardiogram (ECG) performed as a screening for the IPPE (with interpretation and report). G0404 – ECG performed as a screening for the IPPE (tracing only without interpretation and report). G0405 – ECG performed as a screening for the IPPE (interpretation and report only).
Who can bill for Medicare annual wellness visit?
Medicare Part B covers the Annual Wellness Visit (AWV) if it is furnished by a: • Physician (doctor of medicine or osteopathic medicine) • Physician assistant • Nurse practitioner • Clinical nurse specialist • Medical professional (including a health educator, a registered dietitian, nutrition professional, or other ...
Is bloodwork part of a wellness visit?
Does a Wellness Exam Include Blood Work? Yes, a wellness exam can include blood work. However, it's important to note that the specific tests conducted during a wellness exam may vary from person to person.
Is CPT code G0463 covered by Medicare?
Medicare Reimbursement for G0463 CPT Code
Medicare typically reimburses healthcare providers for outpatient clinic visits using the Medicare Physician Fee Schedule. The reimbursement rates for the G0463 CPT code may vary based on the Relative Value Units (RVUs) assigned to the specific procedure.
What is procedure code 44143?
The Current Procedural Terminology (CPT®) code 44143 as maintained by American Medical Association, is a medical procedural code under the range - Excision Procedures on the Intestines (Except Rectum).
What is G code 99213?
Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making.