Physicians: Will 'Welcome To Medicare' Exams Be A Welcome Addition?

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains how CMS structured and revised the Welcome to Medicare preventive visit and why physicians were debating its payment and workload implications. It is relevant to physicians, billing and coding staff, and practice managers who follow Medicare preventive services policy, physician fee schedule updates, and related CMS guidance. The discussion focuses on the exam’s components, split billing for associated EKG services, and CMS’s clarifications about what the visit should cover.

Why This Topic Matters

The policy changes discussed affect how Medicare preventive visits are billed and how practices coordinate services when outside providers perform portions of the exam. Understanding the article helps readers track CMS requirements, reimbursement concerns, and the operational impact on new Medicare patient visits.

Article Sections

  1. Split codes mean physicians can outsource EKG tests

    Discusses the Medicare preventive exam structure, physician concerns about reimbursement, and CMS’s decision to separate the exam from associated EKG-related services.

  2. CMS Makes 'Welcome' Concessions

    Covers CMS clarifications and revisions to the exam’s scope, including changes to the information gathered and the types of covered tests referenced.

What You Will Learn

  • How CMS framed the Welcome to Medicare exam in the physician fee schedule
  • Why physicians raised concerns about reimbursement and service workload
  • How CMS split parts of the exam into separate billing components
  • What types of broad clarifications CMS made to the exam’s scope
  • How CMS described the role of recognized professional organizations in covered tests

Who Should Read This

  • Physicians
  • Medical coders
  • Billing specialists
  • Practice managers
  • Compliance staff

Codes Discussed

  • CPT: 99381
  • CPT: 99382
  • CPT: 99383
  • CPT: 99384
  • CPT: 99385
  • CPT: 99386
  • CPT: 99387
  • HCPCS Level II: G0344
  • HCPCS Level II: G0366
  • HCPCS Level II: G0367
  • HCPCS Level II: G0368

Code Ranges Discussed

  • CPT: 99381-99387

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