A preventive care benefit available to all Medicare Part B patients at no cost to them. AWV focuses on prevention planning rather than clinical examination, with high completion rates and strong reimbursement when bundled with additional screenings.
The Annual Wellness Visit (AWV) is a Medicare preventive benefit established under the Affordable Care Act. It is not a traditional physical exam. Instead, it focuses on establishing or updating a personalized prevention plan, reviewing health risk factors, and identifying services the patient is due for.
Because Medicare waives the patient copay for AWV, completion rates are significantly higher than for other visit types. This makes AWV one of the most effective ways to increase patient engagement, close care gaps, and generate revenue from your Medicare panel, all in a single annual touchpoint.
Revenue opportunity: A practice with 500 Medicare patients completing AWVs at an 80% capture rate, with bundled screenings, can generate $75,000–$120,000+ in annual revenue while dramatically improving preventive care performance metrics.
A common point of confusion: the Annual Wellness Visit is a prevention and planning visit, not a traditional comprehensive physical. Understanding this distinction is essential for proper billing:
AWV uses HCPCS G-codes rather than CPT codes for the primary visit. Additional screenings performed on the same day can be billed with their own codes for incremental revenue:
| Code | Description |
|---|---|
| G0402 | Initial Preventive Physical Exam (IPPE / "Welcome to Medicare" visit) - one-time benefit within 12 months of enrolling in Part B |
| G0438 | Initial Annual Wellness Visit - first AWV after the IPPE period |
| G0439 | Subsequent Annual Wellness Visit - every year thereafter |
| Code | Description |
|---|---|
| G0444 | Annual depression screening - PHQ-2 or PHQ-9, no copay |
| G0442 | Annual alcohol misuse screening - AUDIT-C or similar tool |
| G0136 | Social Determinants of Health (SDOH) risk assessment |
| 99497 | Advance Care Planning (ACP) - first 30 minutes, separately billable |
No copay for patients: Medicare covers AWV and most bundled screenings at 100%, with no patient cost-sharing. This removes the most common barrier to annual visit completion.
CareStream maximizes your AWV capture rate through proactive outreach, structured visit workflows, and compliant billing for all eligible codes:
Identify every Medicare patient due for an initial or subsequent AWV, including those who have never had one.
Automated outreach by phone, SMS, and patient portal to schedule visits before the annual eligibility window closes.
Patients complete the Health Risk Assessment before the visit, reducing in-office time and improving visit quality.
Provider-facing visit templates that capture all required AWV elements efficiently and completely.
Automated flags for eligible same-day screenings (G0444, G0442, G0136, 99497) to ensure no revenue is left on the table.
AWV findings feed directly into care management workflows: overdue screenings, referrals, and follow-up actions are tracked.
All AWV and bundled screening codes are submitted with proper documentation to support audit defense.
We identify, outreach, and complete AWVs for your entire Medicare panel with no additional staff burden required.
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