Medicare Wellness Visit

Medicare beneficiaries are eligible for an Annual Wellness Visit that focuses on establishing and maintaining a personalized prevention 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.  

Annual Wellness Visitand Welcome to Medicare Visit Compare the

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

Health Risk Assessment

The patient must complete a Health Risk Assessment (HRA), which he or she can do at home or in the office prior to the face-to-face encounter. Download the HRA Form (2-pages). Also available in Large Font (3 pages).

 

Information and Materials for the Healthcare Team

Required Elements of the Annual Wellness Visit

Initial Annual Wellness Visit

Requirements for the patient's first Annual Wellness Visit:

  • Administer a Health Risk Assessment (patient can complete prior to face-to-face encounter)
  • Establish a list of current providers and suppliers regularly involved in providing medical care, medications and supplements to the patient
  • Establish the patient’s medical and family history
  • Review the completed Health Risk Assessment
  • Review the patient’s potential risk factors for depression, including current or past experiences with depression or other mood disorders
  • Review the patient’s functional ability and level of safety
  • Obtain height, weight, BMI (or waist circumference, if appropriate), blood pressure and other routine measurements as deemed appropriate, based on the patient’s medical and family history
  • Detect any potential cognitive impairment
  • Establish a written screening schedule or checklist for the patient for next 5-10 years, based on the recommendations by the United States Preventive Services Task Force (USPSTF) and the Advisory Committee on Immunization Practices (ACIP), as well as the patient’s HRA and health status    
  • Establish a list of risk factors and conditions for which primary, secondary, or tertiary interventions are recommended or underway for the patient. Include:
    • any mental health conditions, or risk factors or conditions identified through an Initial Preventive physical Examination
    • a list of treatment options and their associated risks and benefits
  • Furnish personalized health advice to the patient and a referral, as appropriate, to health education or preventive counseling services or programs
  • Furnish, at the discretion of the beneficiary, advance care planning services

 

Subsequent Annual Wellness Visit

Requirements for the patient's subsequent Annual Wellness Visits:

  • Review and update the patient's completed Health Risk Assessment (HRA) Update the patient's medical and family history
  • Update the list of current providers and suppliers regularly involved in providing medical care to the patient
  • Update the patient's medical and family history
  • Obtain height, weight, BMI (or waist circumference, if appropriate), blood pressure and other routine measurements as deemed appropriate, based on the patient’s medical and family history
  • Detect any potential cognitive impairment
  • Update the written screening schedule that was developed at the first AWV
  • Update the list of risk factors and conditions for which primary, secondary, or tertiary interventions are recommended or are underway for the patient
  • Furnishing of personalized health advice to the individual and a referral, as appropriate, to health education or preventive counseling services or programs
  • Furnish, at the discretion of the beneficiary, advance care planning services

 

Source: Medicare Learning Network, The ABCs of the Annual Wellness Visit (AWV)

 

Office Resources

Below you will find materials to help your practice understand the Annual Wellness Visit (AWV), incorporate it into your work flow, and tools you can use with patients to support them in achieving their wellness goals.

About Medicare Wellness Visits

Comparing Types of Medicare Wellness Visits

Annual Wellness Visits Frequently Asked Questions

Scheduling

Scripts for Scheduling Medicare Wellness Visits

Flow Chart for Scheduling a Wellness Visit

Questions Patients May Ask

Implementation

How to Implement the Medicare Wellness Visit

Roles and Responsibilities: Team-Based Care Model (Swim Lane Diagram)

Clinical Workflow for Required Elements of the MWV

Coding

Quick Reference Coding Sheet for Medicare Wellness Visits

Medicare Preventive Services CPT and ICD-10 Codes

 

The Patient Visit

Screening Tools

References and Resources

Latest News

View All

Upcoming Classes & Events

View All
  • Yoga Level II
    Lincolnville ME

    If you have built a strong foundation in beginner yoga, Yoga Level II is just for you. This class is designed for students who have had some yoga...

    Read More
  • Easy Going Yoga
    Rockland ME

    Easy Going Yoga is designed with the older student in mind. Antonia Small, owner of ORYX WORX Fitness, will teach you to stretch, strengthen,...

    Read More