What is the CPT Code for an Annual Wellness Visit?

Medicare billing can be complex, and using the correct CPT codes is essential for both providers and patients. One of the most frequently asked questions is: “What is the CPT code for an Annual Wellness Visit?” This visit helps Medicare beneficiaries stay on top of preventive care and long-term health planning. Let’s explore the details.

CPT Codes for Annual Wellness Visits

Medicare recognizes two main CPT codes for Annual Wellness Visits (AWVs):

• G0438 – Initial Annual Wellness Visit (for first-time beneficiaries).
• G0439 – Subsequent Annual Wellness Visit (for patients who have already had their initial AWV).

AWVs are different from yearly physical exams. They focus on prevention, risk assessment, updating medical history, and developing a personalized care plan.

Why Annual Wellness Visits Matter

For patients, an AWV ensures:

• Preventive screenings are up-to-date.
• Chronic conditions are monitored closely.
• Lifestyle and risk factors are reviewed.
• Personalized health goals are established with the provider.

For healthcare providers, correct CPT coding ensures accurate Medicare reimbursement and reduces the risk of claim denials.

Common Mistakes in Billing Annual Wellness Visits

Confusing AWVs with problem-oriented visits or routine exams is a common error. To avoid denied claims:

• Distinguish AWVs from physical exams clearly.
• Use G0438 only for the first AWV.
• Use G0439 for all subsequent visits.
• Document all Medicare-required elements for each visit.

How EZ Settlement Solutions Can Help

Properly navigating CPT codes and Medicare compliance can be challenging. At EZ Settlement Solutions, we help healthcare providers optimize medical billing services, reduce claim denials, and maximize reimbursements.

We also provide expert support in:

• Revenue Cycle Management
• Compliance and Audit Services

Our team ensures your practice bills Annual Wellness Visits accurately, protecting your revenue and compliance.

Final Thoughts

The CPT codes for Annual Wellness Visits are simple: G0438 for initial visits and G0439 for subsequent visits. Correct coding increases efficiency, ensures compliance, and safeguards revenue.

For official guidance, review Medicare’s Annual Wellness Visit guidelines.