Wiki SDOH Risk Assessment as an Optional AWV Element

[nolagirl]

Does anyone have insight as to why Medicare has the following statement in its MLN Educational Tool Medicare Wellness Visits under AWV Billing regarding SDOH risk assessment as an optional AWV element: The implementation date for SDOH Risk Assessment claims is July 1, 2024. G0136 Administration of a standardized, evidence-based social determinants of health risk assessment tool, 5-15 minutes, became effective January 1, 2024. Thanks.

 

[jkyles]

Hi there, the implementation date is the date Medicare administrative contractors must be able to enforce a policy, such as process claims for a code or enforce an edit.

 

[nolagirl]

Hi there, the implementation date is the date Medicare administrative contractors must be able to enforce a policy, such as process claims for a code or enforce an edit.

Thanks for the info. Does that mean a claim can't be submitted before July 1, 2024? If a claim is submitted before July 1, 2024, will it be denied? I'm not a biller.

 

[jkyles]

It's going to depend on the MAC and how their system is set up. You can always send a claim through and see what happens.