ANNUAL WELLNESS VISIT (AWV) FREQUENTLY ASKED QUESTIONS
Is the AWV the same as a patient’s yearly physical?
No. The AWV isn’t a routine physical some patients may get periodically from their physician or other qualified NPP. Medicare does not cover routine physical exams.
Does the deductible, coinsurance, or copayment apply for the AWV?
No. Medicare waives the coinsurance, copayment, and Part B deductible for the AWV.
Who is eligible for the AWV?
Medicare covers an AWV for all patients who have had Medicare coverage for longer than 12 months after their first Part B eligibility date and who did not 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 physician’s office staff to check eligibility to find out when you are eligible for your next preventive service.
Are clinical lab tests part of the IPPE or AWV?
No. The IPPE and AWV do not include clinical lab tests, but a physician may make appropriate referrals for these tests as part of the Initial Preventive Physical Exam (IPPE) or AWV.
Can my physician bill an AWV and an electrocardiogram on the same date of service?
Generally, the physician 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 physician 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 I provided to this patient?
Physicians 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.
