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Have you had wellness visits with your Med Adv patients this year?
December 2, 2020

This article is for primary care providers caring for our Medicare Advantage members

Building a relationship with your patient is important to 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 any risk factors.

“The annual wellness visit provides time for your primary care physician to take a step back and conduct a comprehensive assessment to look at you and your health holistically,” says Dr. Anthony Zizza, a geriatrician at Landmark Health. See more of Dr. Zizza’s advice here.

Schedule wellness visits with your Medicare Advantage patients by the end of the year

We need your help talking with patients about fall prevention
Our most recent Health Outcome Survey scores indicate that up to 66% of our members surveyed may not be having conversations about fall prevention.

The annual wellness visit is a great opportunity to discuss or reassess fall prevention plans with all Medicare Advantage members. Schedule your patients for an annual wellness visit today!

We understand the demands facing healthcare providers during the COVID-19 public health emergency. Work with your office staff to coordinate these visits. As a reminder, you don’t have to be a physician to conduct an annual wellness visit.

Best practices for annual wellness visits

  • Work with the nurse practitioner or physician assistant in your office to schedule visits for these members
  • Conduct the wellness visit over telehealth

As a reminder, it is important to always check your patient’s Blue Cross ID card and to verify their eligibility and benefits using Online Services to avoid surprise billing.

As a reminder, it is important to always check your patient’s Blue Cross ID card and to verify their eligibility and benefits using Online Services to avoid surprise billing. To access Online Services, log in and click eTools > Online Services.

How to bill for annual wellness visits

Annual wellness visits are covered for all Medicare Advantage members. Use the codes below to bill for this service.

HCPCS code Description
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.

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