Medicare Covers an Annual Wellness Visit. Are you seeing patients for Wellness visit in January 2015?

10/19/2014 4:57 AM

Medicare covers an Annual Wellness Visit (AWV) providing Personalized Prevention Plan Services (PPPS). Medicare covers the AWV for beneficiaries who are not within the first 12 months of their first Part B coverage period and have not received an Initial Preventive Physical Examination (IPPE) or AWV within the past 12 months. You must provide, or provide and refer, all components of the AWV prior to submitting a claim for the AWV.

This document is divided into two sections: the first explains the components included in the first AWV a beneficiary receives; and the second explains the components included in all subsequent AWVs.

Please note, the AWV is a separate service from the IPPE, also known as the “Welcome to Medicare Preventive Visit.”

The AWV includes a Health Risk Assessment (HRA). We included a brief summary of the minimum elements in the HRA. Additionally, the Centers for Disease Control and Prevention (CDC) published “A Framework for Patient-Centered Health Risk Assessments: Providing Health Promotion and Disease Prevention Services to Medicare Beneficiaries.” This framework includes sections about the history of HRAs, definition of the HRA framework and rationale for its use, HRA use and follow-up interventions that evidence suggests can influence health behaviors, and a suggested set of HRA questions. 

For more information about HRAs, refer here.