# Awv - OMG, I know everyone



## NESmith (Feb 21, 2011)

OMG, I know everyone is probably getting tired of all the questions about the new Annual Wellness Visits, but I have one more. I thought I had this straightened out but now I have a provider that has confused me. So here goes; if you have an established patient and they are past their IPPE, let's say about 1 yr, do you bill the initial AWV (G0438) or do you bill the subsequent (G0439) I say the initial because this is the first one the patient has had and then any after that would be the subsequent. Please let me know you thoughts and also does anyone have a form they are using for these visits? As always Thanks for your help.


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## RebeccaWoodward* (Feb 21, 2011)

You're correct...It would be the initial.

*AWV*

As a result of the ACA, effective January 1, 2011, Medicare will pay for an AWV for a beneficiary who is *no longer within 12 months after the effective date of his/her first Medicare Part B coverage period, and he/she has not received either an IPPE *or an AWV providing PPPS within the past 12 months. Medicare pays for only one first AWV (HCPCS G0438), per beneficiary per lifetime, and all subsequent wellness visits must be billed as a subsequent AWV (HCPCS G0439).

Beneficiaries in their first 12 months of Part B coverage will continue to be eligible for only the IPPE (see 30.6.1.1.A.1).

Page 16

http://www.cms.gov/Transmittals/downloads/R2109CP.pdf

I found one template.  You could always modify it to your physicians preferences.  The only area I didn't like was the depression questionnaire.

http://www.klahealthcare.com/sites/240/uploaded/files/Medicare_Well_Patient_Visit.pdf

I prefer the Beck's questionnaire...

http://www.idahopmr.com/forms/Beck's Questionnaire.pdf


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## NESmith (Feb 21, 2011)

Thank You Rebecca, you information is great.


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