ANNUAL WELLNESS VISIT (AWV) FREQUENTLY ASKED QUESTIONS
Is the AWV the same as a patient’s yearly physical?
No. An AWV isn’t a routine physical some patients may get. Medicare does not cover routine physical exams.
An AWV is not a “head-to-toe” physical or intended to be an evaluation or management of any acute problems and
chronic illness. This type of visit can be completed by telehealth, and no physical exam is required for an AWV.
Does the deductible, coinsurance, or copayment apply for the AWV?
No, however, if the patient receives services in addition to an AWV exam, including management of chronic
conditions and prescription medications or addressing current problems, an additional fee will apply.
Who is eligible for the AWV?
Medicare covers an AWV for all patients who’ve had Medicare coverage for longer than 12 months after their first
Part B eligibility date and who didn’t have an Initial Preventive Physical Exam (IPPE) or AWV within those past 12
months. Medicare covers only one IPPE per patient per lifetime and one additional AWV every 12 months after the
date of the patient’s last AWV (or IPPE). Ask your provider’s office staff to check eligibility to find out when you are
eligible for your next preventive service.
Are clinical labs or other tests included in an AWV?
No. An AWV does not include ordering or reviewing clinical lab tests or other exams including radiology. These may
be ordered by your provider for management of other conditions outside of the annual wellness visit.
Can my provider bill an AWV and an electrocardiogram on the same date of service?
Generally, the provider may provide other medically necessary services on the same date as an AWV. The deductible
and coinsurance or copayment applies for these other medically necessary and reasonable services.
How does my provider know if I have already gotten my first AWV from another provider and whether to
bill for a subsequent AWV even though this is the first AWV provided to this patient?
Providers have different options for accessing AWV eligibility information depending on where they practice. They
can check eligibility to find when a patient is eligible for their next preventive service.
Who can perform an AWV?
An AWV can be performed by a physician, nurse practitioner, or physician’s assistant. Under the direct supervision of a
physician, the visit could be performed by a licenced professional in your provider’s office.
What is covered by an AWV?
- Check of height, weight, and blood pressure
- Health Risk Assessment (health status, injury risk,
behavioral risk)
- Review of functional ability and level of safety (hearing
impairments, risk of falling, etc.)
- Review of activities in patients’ daily life and level of
safety at home
- Review and update medical history and family history
- Update current providers, durable medical equipment
(DME) suppliers, and medications (this does not
include management of any prescriptions which may
require review of kidney and liver function and dose
adjustment)
- Review cancer screening schedule or checklist
- Review of depression risk factors
- Establish screening schedule
- Establish list of patient’s risk factors and conditions
- Advanced care planning at the patient’s discretion
(advanced directives)
- Review current opioid prescriptions
- Screening for substance use disorders
- Social determinants of health risk assessment
(optional)
- Screening for cognitive impairment (Alzheimer's/
dementia, depression, etc.) This can be completed by
observations and/or on reports by you or others
- Health advice aimed at promoting wellness, referrals
to health education and/or counseling, preventative
advising related to, but not limited to, a healthy
weight, physical activity, smoking cessation, fall
prevention, nutrition, etc.
What if I get an EKG on the same day of my AWV?
You will be charged the applicable fee for the EKG separately, as well as any evaluation and management rendered
related to the condition that required the EKG.
