Annual Wellness Visit Resources

The Medicare Annual Wellness Visit (AWV) was introduced in 2011 as part of the Affordable Care Act. This visit is very important to complete in both your traditional Medicare and Medicare Advantage patient population. Medicare AWVs are free of charge for its members and covers preventive care screenings, counseling, vital signs, advance care planning and some vaccinations. Some key points to remember:

  • Traditional Medicare does not cover a physical exam (with the exception of the Initial Preventive Physical Exam (IPPE) during the members first 12 months of enrollment).   
  • Medicare AWVs provide a great opportunity to complete many of the Medicare quality measures along with assessing HCC risk coding.
  • Medicare Advantage plans also require an AWV be provided following the CMS guidelines.  Most MA plans cover a routine physical exam. Please verify with the patients insurance for specifics; some plans allow the physical exam to be performed with the AWV.
  • It is common practice to schedule the patient for a follow up visit 2 to 4 weeks after the AWV to address their chronic conditions and review any lab work that may have been ordered during the AWV. 

Linked below are resources commonly used during this visit along with an AWV coding tip sheet. See the IPPE and AWV hyperlinks embedded in the coding tip sheet for guidance on what should be addressed during these visit. The hyperlink at the top of the tip sheet is a great resource that provides the coverage, frequency and coding for all preventive services.