Annual Wellness Visit (AWV)

by  Wyn Staheli, Director of Research
August 1st, 2017

Annual Wellness Visits (AWVs) are a preventive medicine service. It is a comprehensive evaluation and management service which is covered by payers as part of the Affordable Care Act (ACA)'s covered services and there are typically no deductibles or co-pays.

These exams are sometimes referred to as well baby, well-child or well-adult visits. They include:

Even though all payers cover an AWV, be aware of individual payer requirements regarding which services must be performed and documented as part of the visit. For example, Medicare's AWV requires a Personalized Prevention Plan of Service (PPPS) and a Health Risk Assessment. Medicare also states that the AWV is not the same thing as their Initial Preventive Physical Examination (IPPE) or an annual routine physical checkup.

POSSIBLE CODES:

Child99381, 99382, 99391, 99392, 99461

Adult99383, 99384, 99385, 99386, 99387 99393, 99394, 99395, 99396, 99397 G0402, G0438, G0439, S0610, S0612, S0613

NOTE: typically allowed with any diagnosis code since this is a well visit however, be aware of individual payer requirements before billing.

During the AWV, additional preventive services may also be performed and billed separately - where appropriate. For example, if during the Health Risk Assessment portion, tobacco use was identified, the healthcare provider may provide tobacco use cessation counseling and bill that service in addition to the AWV code. Keep in mind that additional services provided beyond the AWV are covered at the payers typical rate. Co-pays and/or deductibles may apply.

The following are some commonly covered preventive care services which may also be provided during the AWV and are billed separately from the AWV.

 

References:

Annual Wellness Visit (AWV). (2017, August 1). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/annual-wellness-visit-awv-31427.html

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