Annual Wellness Visit (AWV), Including Personalized Prevention Plan Services (PPPS)
December 14th, 2010
We waited and waited on a Medicare Learning Network publication on the annual wellness visits before publishing yesterday's newsletter. Guess what? Today one was finally published!
Two new HCPCS codes, G0438 - Annual wellness visit, includes a personalized prevention plan of service (PPPS), first visit, (Short descriptor – Annual wellness first) and G0439 - Annual wellness visit, includes a personalized prevention plan of service (PPPS), subsequent visit, (Short descriptor – Annual wellness subseq) will be implemented January 1, 2011
You can view the official "word" from Medicare on the new wellness exam benefits at: http://www.cms.gov/MLNMattersArticles/downloads/MM7079.pdf.
The article details nicely what is required to be documented for the visit. Remember, the wellness visits begin after a patient has completed one year with Medicare. The first year the patient should be given the IPPE exam. For information on documenting that exam visit: http://www.cms.gov/MLNProducts/Downloads/MPS_QRI_IPPE001a.pdf.
A patient's first Annual Wellness Visit pays approximately $115 and is not subject to either coinsurance or deductibles. Subsequent Annual Wellness Visits pay about $77.
Remember too that this is a requirement of the Affordable Care Act. Unless an insurance company has applied for or falls under an exception, similar benefits should be available for ALL PATIENTS!
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