Identify and Address Health Risks with Annual Wellness Visits Software

Medicare Part B covers an Initial Preventive Physical Exam if it is furnished by a Physician (doctor of medicine or osteopathic medicine) or another qualified non-physician practitioner (physician assistant, nurse practitioner, or clinical nurse specialist).

Medicare provides coverage of the Initial Preventive Physical Exam (IPPE) for all beneficiaries who receive the IPPE within the first 12 months after the effective date of their first Medicare Part B coverage period. This is a one-time benefit per Medicare Part B enrollee. A

Medicare provides coverage of an Annual Wellness Visit (AWV) for a beneficiary who is no longer within 12 months after the effective date of his or her first Medicare Part B coverage period and who has not received either an Initial Preventive Physical Exam (IPPE) or an AWV within the past 12 months.

Annual wellness visit software should have below key features to complete any AWV of a patient.

1. Appointment scheduling: Manage patient appointments and send automated reminders.
2. Health risk assessment (HRA) integration: Integrate with standardized HRAs to collect patient data electronically.
3. Care plan development: Create and share personalized care plans with patients.
4. Documentation management: Streamline documentation of AWV components and generate reports.
5. Coding and Billing Assistance: Ensure accurate coding and billing for AWVs according to relevant guidelines.

The following components must be included in a patient’s wellness visit:

1. A health risk assessment.
2. A review and update of medical and family history.
3. A review of current providers, prescriptions/medications, and durable medical equipment suppliers.
4. Height, weight, blood pressure, BMI, and other routine measurements.
5. Personalized health advice, health education, and preventative counseling.
6. A list of identified risk factors, current medical and mental health conditions, and recommended treatment options.
7. A cognitive impairment screening.
8. A 5 to 10-year screening schedule for appropriate preventive services.
9. A review of the patient’s functional ability and level of safety,including screening for hearing impairments, risk of falling,activities of daily living, and level of home safety.
10. Identification of patients at risk for alcohol, tobacco, and opioid abuse.

There are three types of wellness visits: Initial Preventive Physical Examination (IPPE), an Initial Annual Wellness Visit, and the Subsequent Annual Wellness Visit. Each entails a different billing code as well as specific qualifiers for each program.

1. Initial Preventive Physical Examination (G0402): Patients may only receive this benefit within the rest 12 months of their Medicare enrollment. Commonly referred to as the “welcome to Medicare visit,” it is considered a once in a lifetime assessment and after the initial eligibility period, the patient cannot receive an Initial Preventive Physical Examination. It is also dependent on the health risk assessment.
2. Initial Annual Wellness Visits (G0438): Similar to an Initial Preventive Physical Examination, except it is available to a patient after 11 months of Medicare enrollment. This is for patients that miss their window for an Initial Preventive Physical Examination. However, if the patient does complete an Initial Preventive Physical Examination, they must still complete the Initial Annual Wellness Visit. This screening also includes an optional cognitive exam and end-of-life planning.
3. Subsequent Annual Wellness Visit (G0439): Is the yearly follow-up to an Initial Annual Wellness Visit. Eleven full months after the Initial Annual Wellness Visit, a patient can attend these visits to modify and maintain their preventive care plan, based on how their health is at any given time.