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Contact your Medicare patients to schedule their annual wellness visit (AWV)


What’s an AWV?


AWVs allow practices to gain information about patients, including medical and family history, health risks and vitals. An AWV, which should not be confused with a complete physical examination, reviews the patient's wellness and develops a personalized prevention plan.


AWV components


  • Establish medical and family history
  • Establish a list of current providers and suppliers
  • Take height, weight, BMI and BP
  • Detect any cognitive impairment
  • Review potential depression risk factors
  • Review functional ability and level of safety


AWVs can be performed by a physician, physician assistant, nurse practitioner, certified clinical nurse specialist or a medical professional under direct supervision of a physician (including health educators, registered dietitians and other licensed practitioners).


Provider benefits of performing AWVs include:


  • Building a complete medical history
  • Strengthening the provider/patient partnership
  • Increasing patient engagement
  • Providing proactive care to patients
  • Gathering quality metrics

Patient benefits of receiving an AWV include:


  • Overall wellness and prevention
  • Early disease detection and prevention
  • Maximized wellness

AWV documentation


Document diagnoses and conditions to accurately reflect severity of illness and risk of high-cost care.


AWV coding


Aetna® covers the cost of the beneficiary’s AWV. The beneficiary has zero out-of-pocket expenses for an AWV.* A copay becomes applicable when a separately billed, medically necessary service is performed on the same day (append modifier -25 to the evaluation and management code).


The three Healthcare Common Procedure Coding System (HCPCS) codes used to report AWV services are:


  • G0402-IPPE Welcome to Medicare visit (once per lifetime within the first 12 months of coverage)
  • G0438-Initial visit (once per lifetime if IPPE was not received within the first 12 months of coverage)
  • G0439-Subsequent visits/annual benefit for beneficiaries (no lifetime limit)

ICD-10 Z codes must be reported for wellness exams.


  • Z00.00-Encounter for general adult medical examination without abnormal findings
  • Z00.01-Encounter for general adult medical examination with abnormal findings

For additional information, send us an email message.


*Patients might have to pay all or part of the cost for additional services (lab, X-rays, etc.) ordered during an AWV. Please discuss any additional services with the patient beforehand so that they understand their financial responsibility.

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.

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