This article is for primary care physicians caring for our Medicare Advantage members
Building a relationship with your patient has a significant impact on the quality of care that you provide. It can help you get a better picture of the patient’s health, including family history or predisposition to conditions that can be managed early on.
Annual wellness visits allow you to do just that; spend time with your patient, learn about their health behaviors, and help them find ways to lower the risk of developing disease complications. During these visits, be mindful of any cultural beliefs or barriers relevant to your patient. Disregarding these specific needs can often amplify health inequities, so it’s important to be sensitive and aware of your patient’s background.
Read more in our Coverage story: How a wellness program saved a life.
As a reminder, it is important to always check your patient’s Blue Cross ID card and to verify their eligibility and benefits using ConnectCenter to avoid surprise billing.
You can also learn more about additional support programs that are available to your patient by visiting our Member Support & Assistance Programs page.
Annual wellness visits are covered for all Medicare Advantage members. Use the codes below to bill for this service.
|G0402||Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment|
|G0438||Annual wellness visit; includes a personalized prevention plan of service (PPS), initial visit|
|G0439||Annual wellness visit, includes a personalized prevention plan of service (PPS), subsequent visit|
|For telehealth services|
|Use modifier GT, 95, G0, or GQ with the applicable place of service code to differentiate a telehealth visit from an in-person encounter with the patient.|
As always, we thank you for the care that you provide to your patients—our members.