Primary Care Coding Alert
Recall Whether Incident - to Applies to AWVs
Question: I know that a physician is not required to perform a patient’s Annual Wellness Visit (AWV), but does that mean I bill the visit as incident-to when someone other than the doctor performs the service? Also, can the doctor perform this service over the phone? Maryland Subscriber Answer: To address the first question, AWVs are Medicare-covered services within their own benefit category. As such, they are not subject to standard incident-to billing guidelines. This means they must be billed by the performing provider, whether this is a physician or non-physician practitioner (NPP). Telehealth (either audio-visual or audio-only) is an option, provided you meet all the documentation requirements. Codes G0438 (Annual wellness visit; includes a personalized prevention plan of service (PPPS), initial visit) and G0439 (Annual wellness visit, includes a personalized prevention plan of service (PPPS), subsequent visit) are on the Medicare telehealth list, which indicates audio-only interaction may meet the requirements. To review the requirements in detail, check out: www. novitas-solutions.com/webcenter/portal/MedicareJH/ pagebyid?contentId=00027460.
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Recall Whether Incident - to Applies to AWVs
Question: I know that a physician is not required to perform a patient’s Annual Wellness Visit [...]
