Physical Exams: What You Need To Know About 'Welcome To Medicare' Exams

Why This Topic Matters

The guidance affects how practices recognize the new Medicare preventive exam, distinguish it from separately reportable services, and coordinate billing when an E/M visit occurs on the same date. It also matters because the article ties the new Medicare benefit to fee schedule implementation and to established CPT reporting for associated services.

Article Sections

1. Coverage and Implementation Background

   Introduces the Medicare fee schedule update and explains the general timing and eligibility framework for the new benefit. It also places the discussion in the context of CMS implementation guidance.

2. What the Exam Includes and Excludes

   Summarizes the broad components CMS expects to be addressed during the introductory exam and notes the types of services that are not part of the base exam. The section also discusses the related preventive screening topics referenced in the article.

3. Coding and Payment Guidance

   Describes how CMS positioned the new Medicare G-code in relation to existing CPT reporting and fee schedule valuation. It also covers the article’s discussion of other services reported separately and general payment context.

4. Same-Day E/M Reporting

   Explains the article’s discussion of reporting an evaluation and management service on the same date as the introductory exam and the conditions CMS associates with separate billing. It also notes the cost-sharing point mentioned in the guidance.