Annual Wellness Visit (AWV)
Annual Wellness Visit
A Medicare-covered preventive visit (G0438 initial, G0439 subsequent) focused on personalized prevention plans.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Billing
- Acronym for
- Annual Wellness Visit
- Primary sources
- 1
- Workspace handoff
- revenue audit →
Where this comes up
This shows up in revenue-cycle work — claim scrubbing, charge entry, posting, A/R follow-up, and month-end close. Billers and practice managers hit this term when reconciling a payment, working a denial queue, or auditing why a claim aged past 60 days.
Full definition
What it is in practice
CMS covers an initial AWV (G0438) at 11+ months after Part B effective and subsequent AWVs (G0439) once per 12 months. The AWV includes a Health Risk Assessment and a written prevention plan.
How it shows up in your practice
Same-day AWV + problem visit (99214-25) is permitted when documentation supports separate work. Watch for modifier-25 requirements and payer-specific rules.
Sources
- CMS — Medicare Annual Wellness Visithttps://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/preventive-services/medicare-wellness-visits.html
Audit AWV capture in Revenue Audit
Open revenue audit →Related terms
- BillingModifier 25CPT modifier indicating that a significant, separately identifiable E/M service was performed by the same provider on the same day as another procedure or service.
- BillingPreventive ServicesUSPSTF Grade A and B recommendations and ACIP-recommended vaccines that ACA-covered plans must cover without cost-sharing.
- BillingG2211 (Visit Complexity Add-on)Medicare HCPCS add-on code recognizing the visit complexity inherent to evaluation and management services associated with primary care and certain longitudinal care.
- BillingInitial Preventive Physical (IPPE / Welcome to Medicare)One-time Medicare preventive visit (G0402) furnished within 12 months of Part B enrollment.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryInitial Preventive Physical (IPPE / Welcome to Medicare)One-time Medicare preventive visit (G0402) furnished within 12 months of Part B enrollment.
- GlossaryG2211 (Visit Complexity Add-on)Medicare HCPCS add-on code recognizing the visit complexity inherent to evaluation and management services associated with primary care and certain longitudinal care.
- GlossaryModifier 25CPT modifier indicating that a significant, separately identifiable E/M service was performed by the same provider on the same day as another procedure or service.
- GlossaryPreventive ServicesUSPSTF Grade A and B recommendations and ACIP-recommended vaccines that ACA-covered plans must cover without cost-sharing.
- BillingModifier 25: When to Use It and Common MistakesWhen to use modifier -25, when to skip it, and the common mistakes that trigger audits and denials.
- BillingAWV + Problem Visit Same Day: How to Bill CorrectlyYes, you can bill AWV and a problem visit the same day. Here's how to do it correctly with modifier -25.
- BillingPlace of Service Codes: Which One to Use and Why It Changes Your ReimbursementPOS 11 vs 21 vs 02 vs 10. How the two-digit code on your claim determines whether you get office or facility rates.
- BillingUB-04 Billing: Bill Types, Revenue Codes, and Occurrence Codes ExplainedBill type 111 vs 131, revenue code 0250, occurrence span code 70. Every UB-04 field explained in plain English.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.