DecisionHealth, DecisionHealth - 2012 Issue 10 (October)

Benchmark of the Week: AWV with modifier 25 denial rates by specialty, 2011

This chart shows the annual wellness visit (AWV) denial rates for the 13 specialties that billed AWVs most frequently in 2011, the first year Medicare allowed practices to bill wellness visits. For each specialty, the overall denial rate is on the left; on the right is the denial rate for AWVs appended with modifier 25 (Separately identifiable E/M service). Note: This data, derived from a Part B News analysis of Medicare claims data, combine the overall service counts and denied service counts of the two AWV codes, G0438 (initial visit) and G0439 (subsequent visit).

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