Annual Wellness Visit Through Telehealth

Last update: Sept. 30, 2020

The Annual Wellness Visit (AWV) might not be the first service that comes to mind when you think of using telehealth. However, CMS understands the importance of the AWV and has waived restrictions on telehealth visits. 

Why is performing Annual Wellness Visit via Telehealth Important?

• Allows care teams to proactively engage patients
• Identifies and meets care needs before they become acute enough to require the patient to access an in-person healthcare setting
• Assists in identifying and counseling on risky health behaviors
• Creates an opportunity for care teams to identify patients who would benefit from Chronic Care Management (CCM), which is especially important during periods of shelter-in-place orders.

Requirements

 The specific requirements included in the AWV essentially allows a practice to be reimbursed for reaching out to its patients to educate them about their health risks and the current crisis. CMS is also allowing the visit to be completed by clinical staff under physician supervision. It is a great way to use clinical staff who may otherwise be idle (or worse, furloughed) during the pandemic to grow a telemedicine program.

All the normal service and documentation requirements of the in-person AWV remain the same for a telehealth AWV. Billing and coding use the same CPT and ICD codes, but you should add modifier -GT to signify it was performed via telehealth. During the pandemic, Medicare is reimbursing telehealth AWVs at the same rate as it would if the visit were completed in person.

 Telehealth Correct Coding for Wellness Visit

Allowable AWV Telehealth

• G0438 - Initial Annual Wellness Visit
• G0439 - Subsequent Annual Wellness Visit

Not Allowable by Telehealth

• G0402 - Initial Preventive Physical Exam (IPPE)

You can see a full list of the services Medicare is allowing via telehealth on the CMS website.