Medicare Wellness Visit Guidelines

Medicare beneficiaries are eligible for an Annual Wellness Visit that focuses on establishing and maintaining a personalized prevention plan. Unlike the physical exam, the Medicare Wellness Visit is an opportunity for the provider and the patient to have a conversation about important topics such as home safety, health risks, advance directives and developing a care plan.  

A beneficiary is eligible for his or her first Annual Wellness Visit if he or she:

  • has had Medicare Part B coverage for at least 12 months, and
  • has not received either an Initial Preventive Physical Examination (IPPE or "Welcome to Medicare" visit) within the past 12 months.

See Comparing Types of Medicare Wellness Visits for details.

After the first Annual Wellness Visit, beneficiaries are eligible for subsequent Annual Wellness Visits every 12 months.

Provider Resources

Below you will find materials to help your practice understand the Annual Wellness Visit (AWV) and incorporate it into your work flow.

 

Scheduling

Scripts for Scheduling Medicare Wellness Visits

Best Practice Workflows

Roles and Responsibilities: Team-Based Care Model (Swim Lane Diagram)
Scheduling Wellness or Physical Workflow
Clinical Workflow
Provider Workflow
Medicare AWV Quick Start Guide (For EPIC users)

MaineHealth Accountable Care Organization Annual Wellness Visit and Annual Physical Coverage

Medicare and Medicare Advantage Calendar Year 2023

 

Medicare Wellness Visit

The Initial Preventative Physical Examination (IPPE)  (Medicare Learning Network)

The Medicare Wellness Visit (Medicare Learning Network)

Preventive Services

Medicare Preventive Services Educational Tool  (Medicare Learning Network)
Information on coding, coverage requirements, and patient cost-sharing for each Medicare preventive service.

U.S. Preventive Services Task Force Tools for Primary Care Providers

Aging & Older Adult Care

MaineHealth provides programs, services and resources to help older adults protect their health and enjoy life. Learn more.