Daniel Bluestein, MD, CMD, is a primary care physician and an expert on the revenue potential from the Medicare Annual Wellness Visit (AWV), added as a benefit of the Affordable Care Act in 2011.
Here’s what he says you should know to maximize this specific visit for your patient and for your practice.
1. It’s different from and better than a “regular” physical.
The AWV is an opportunity to really coordinate care, he says. It’s a time to talk proactively about the “whole” patient, especially their medical and family history and current health conditions, along with medications and supplements. The provider can also obtain specific vitals, such as height, weight, body mass index, blood pressure and vision, and discuss recommended screenings and vaccinations.
2. It pays the practice back.
Bluestein says that AWV can be reimbursed over and above the standard office visit Current Procedural Terminology (CPT) codes, and has some other perks as well.
“If necessary, providers can still add a significant, separately identifiable evaluation and management service code from the same physician on the same day of the procedure or other service if applicable,” Bluestein says.
The wellness visit is also a golden opportunity to discuss the extremely important topic of advanced care planning and for referrals to community-based health resources if applicable. The CPT code 99497 for the first 30 minutes of advanced care planning is $86 and for each additional half-hour is $75.