From the Research
The CPT code for an annual wellness visit is G0438 for the initial visit and G0439 for subsequent annual wellness visits. To use these codes:
- G0438: Use for the patient's first-ever Medicare annual wellness visit
- G0439: Use for all subsequent annual wellness visits These visits are covered once every 12 months by Medicare for eligible beneficiaries. They focus on preventive care, health risk assessment, and creating a personalized prevention plan. Key components of the annual wellness visit include:
- Health risk assessment
- Review of medical and family history
- Developing or updating a list of current providers and prescriptions
- Detection of cognitive impairment
- Personalized health advice
- Screening schedule for appropriate preventive services It's essential to note that these codes are for wellness visits, not for problem-oriented visits. If significant time is spent addressing specific health problems during the visit, it may be appropriate to bill an additional evaluation and management (E/M) code with modifier -25, as supported by the study 1. Using the correct code ensures proper reimbursement and helps track the provision of preventive services, which are crucial for maintaining patient health and reducing long-term healthcare costs, as highlighted in the study 2. The implementation of annual wellness visits has been shown to increase the completion of recommended preventive services, such as advance care planning, depression screening, and alcohol misuse screening, as demonstrated in the study 2. Additionally, the use of virtual practice-tailored interventions can increase the utilization of annual wellness visits and preventive services, as shown in the study 2.
The annual wellness visit provides an opportunity for clinicians to review preventive health recommendations and screen for geriatric syndromes, as discussed in the study 3. The visit can be led by various healthcare professionals, including pharmacists, as shown in the study 4, and registered nurses, as demonstrated in the study 5. The key components of the annual wellness visit, as outlined above, are essential for maintaining patient health and reducing long-term healthcare costs.
In terms of morbidity, mortality, and quality of life, the annual wellness visit plays a crucial role in preventing illnesses and detecting health problems early, which can improve patient outcomes and reduce healthcare costs, as supported by the study 2. The visit also provides an opportunity for personalized health advice and screening, which can help patients make informed decisions about their health and well-being. Overall, the annual wellness visit is an essential component of preventive care, and using the correct codes ensures proper reimbursement and tracking of these services.