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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