Mark asks if his doctor coded his full routine physical exam properly using CPT code 99397, which is not covered by Medicare, or if the doctor should have used the Annual Wellness Visit code, G0438 (or G0439), which is covered by Medicare. What’s the difference? Which code does Medicare pay?
Medicare provides coverage for Annual Wellness Visits. This benefit was included in the Affordable Care Act of 2010. Medicare has come up with two HCPCS codes for these well visits for medical billing purposes. The codes are G0438 and G0439.