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Top 5 Resources for Billing Medicare Annual Wellness Visits G0438

Health Insurance Companies Process 1 in 5 Claims Wrong

Guide on How to Bill G0438 and G0439

Have you been struggling billing Annual Wellness Visits? Having trouble finding the right information online all in one place?

There is a lot of confusion out there on how to properly bill Annual Wellness Visits (AWV) G0438 and G0439. We get
a lot of questions from other practices on how to bill the AWV and what is included.

Some practices are performing a full routine physical exam, which is not an Annual Wellness Visit. Others do not know what questions they must ask or the documentation requirements in order to even be able to bill a G0438 or G0439. If there is an audit, you may have to pay back thousands of dollars to Medicare.

So, to train our billers and help us advise the medical practices we service, we have come up with a list of resources from Medicare that we use internally at our billing company.

This list includes:

  1. A Quick Reference Information Sheets on the AWV
  2. Another Quick Reference on Preventative Services
  3. Booklet on Providing the AWV
  4. Annual Wellness Visit and the PPPS
  5. and a 298 page Booklet on Preventative Services

We want to share our list of the Top 5 Medicare Resources for Billing Annual Wellness Visits we use to bill the AWV with you. Just click the button below and give us your email to get your copy.

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Do you have other resources you use? Having issues with billing AWVs properly? Let me know in the comments below.

is a 20 year veteran of healthcare having managed medical practices. He advises medical practices, physicians and practice administrators on how to run their practice and manage their medical billing and revenue cycle management. Manny speaks, blogs and makes videos at www.CaptureBilling.com, a blog that is tops in the medical billing and coding field. READ MORE

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6 Responses to Top 5 Resources for Billing Medicare Annual Wellness Visits G0438

  1. For our 2016 claims, Medicare is no longer paying for an E/M code (with mod 25) and an AWV at the same time. Do you have any insight into this? They’ve always paid both on the same day. Thank you.

  2. Manny,

    I read your blog responses but I am still not sure:
    I have several patients who are new to my practice but not new to medicare.

    If they are NEW TO ME do I by default bill a G0438 or do I need to find out if they have already had their once in a lifetime G0438 and then make the decision to bill G0438 or g0439?

  3. Hi Manny,

    Do you have any guidelines/policies in writing on how to bill for consultation to workers comp carriers? Can the case manager act as the ‘referring dr?’

    Any of your inputs is highly appreciated.



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