What HCPCS code should be used to bill a Medicare annual wellness visit for a new patient versus an established patient?

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Medicare Annual Wellness Visit Billing Codes

For Medicare Annual Wellness Visits, use HCPCS code G0438 for the initial "Welcome to Medicare" preventive visit or first Annual Wellness Visit, and G0439 for subsequent Annual Wellness Visits in following years.

Specific HCPCS Codes for Annual Wellness Visits

The Medicare Annual Wellness Visit is a distinct preventive benefit created in 2011 under the Affordable Care Act, separate from standard evaluation and management (E/M) codes 1.

Code Selection Based on Patient Status

  • G0438: Bill this code for the first Annual Wellness Visit after a patient becomes eligible for Medicare, or for patients who have never had an Annual Wellness Visit before 1

  • G0439: Bill this code for subsequent Annual Wellness Visits in years following the initial visit 1

Key Distinction from Standard Office Visits

Do not use standard office visit codes (99201-99205 for new patients or 99211-99215 for established patients) when billing for an Annual Wellness Visit. These are fundamentally different services with different purposes and billing requirements 2.

  • Standard E/M codes (99201-99215) are for addressing active medical problems and acute/chronic disease management 2, 3
  • Annual Wellness Visit codes (G0438/G0439) are specifically for preventive health screening, health risk assessment, and personalized prevention planning 1, 4

Billing Both Preventive and Problem-Focused Care

If you address both preventive care (Annual Wellness Visit) AND active medical problems during the same encounter, bill both the preventive code (G0438 or G0439) and an appropriate E/M code (99201-99215) with modifier -25 appended to the E/M code. 2

  • The modifier -25 indicates that the E/M service was a significant, separately identifiable service from the preventive visit 2
  • Documentation must clearly support that both services were medically necessary and distinct 2

Common Pitfalls to Avoid

  • Do not confuse "new patient" vs "established patient" status with Annual Wellness Visit coding. The distinction for G0438 vs G0439 is based on whether this is the patient's first or subsequent Annual Wellness Visit, not their relationship with your practice 1

  • Do not bill standard preventive medicine codes (99381-99397) for Medicare patients. Medicare does not reimburse these codes; use G0438/G0439 instead 2

  • Ensure cognitive assessment is documented, as this is a required component of the Annual Wellness Visit per CMS regulations 4

References

Research

The Medicare Annual Wellness Visit.

Clinics in geriatric medicine, 2018

Guideline

Current Billing Guidelines for E/M and Diagnostic Testing Codes

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Evaluation and Management Coding Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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