Annual Wellness Visits
Who is eligible for the AWV?
Medicare covers an Annual Wellness Visit (AWV) for all beneficiaries who are no longer within 12 months after the eligibility date for their first Medicare Part B benefit period, and who have not had either an Initial Preventive Physical Examination (IPPE) or an AWV within the past 12 months. Medicare pays for only one first AWV per beneficiary per lifetime and one subsequent AWV per year thereafter.
Is the AWV the same as a beneficiary’s yearly physical?
No. The AWV is not a routine physical that some older adults may get periodically from their physician or other qualified non-physician practitioner. Medicare does not cover routine physical examinations.
Are clinical laboratory tests part of the AWV?
No. The AWV does not include any clinical laboratory tests, but you may make appropriate referrals for such tests as part of the AWV.
Do deductible or coinsurance/copayment apply for the AWV?
No. Medicare waives both the coinsurance or copayment and the Medicare Part B deductible for the AWV.
Can I bill an electrocardiogram (EKG) and the AWV on the same date of service?
Generally, you may provide other medically necessary services on the same date of service as an AWV. The deductible and coinsurance or copayment apply for these other medically necessary services.