Time to Revisit Medicare Prevention“Welcome to Medicare” visits service the needs of Medicare patients and help take preventive measures for patient care. Many beneficiaries do not take advantage of these services. Continue reading below for what practices should do to increase the use of these services.

By Ginger Avery,
CPC, CPMA, CRC
July 6, 2021

Medicare Initial Preventive Physical Examinations (IPPE) G0402, commonly referred to as “Welcome to Medicare” visits) and Annual Wellness Visits (AWV) G0438, G0439 are services specifically designed to address preventive needs for the Medicare patient population. Often found to be underutilized, these high-paying services ($135 – $171), are available to every Medicare beneficiary.

Data shows that only about 17% of beneficiaries took advantage of these unique services in 2019. It appears that a large Medicare patient population (approximately 83%) is not receiving these helpful services that also have the potential to provide more revenue to your bottom line.

Practices should:

  1. Recognize the value Medicare preventive services bring to their patient population and to the practice.
  2. Assure that the clinic’s Medicare patients have access to these services.
  3. Have a solid understanding of evaluation and documentation requirements.
    a. Can be time-based, including clinical staff time; specific guidelines apply
    (see 2018 MCFS Addenda and CPT Assistant January 4, 2018).
    b. Utilize helpful tools and templates paired with clear documentation of services provided.
  4. Organize workflows and recognize appropriate staffing requirements.
  5. Write applicable policies.

References:
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/preventive-services/medicare-wellness-visits.html

PartBNews June 28, 2021 Benchmark of the week: Crawling forward, extra-time preventive service codes find small favor