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Issue Number - Name
0028 - Annual Wellness Visits (AWV)
Review Type
Automated
Claim Type
Physician/ Non-physician Practitioner
Region and State
RAC 1-4
All States
Date Approved
2017-03-29

Description

Annual wellness visit includes a personalized prevention plan of service [pps]. The initial visit is a "one time" allowed Medicare benefit per beneficiary.

Affected Codes

  • G0438

Applicable Policy References

  • Title XVIII of the Social Security Act, §§1861(s)(2)(FF) and 1861(hhh)
  • CMS Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 280.5,  Effective date 5/10/2013
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 12, Section 30.6.1.1, Effective date 1/27/2014
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 18, Sections 140–140.8, Effective date 1/1/2011