The Annual Wellness Visit (AWV)
Under the Affordable Care Act, Medicare beneficiaries may now receive coverage for an Annual Wellness Visit (AWV), which is a yearly office visit that focuses on preventive health. During the AWV, healthcare providers will review a patient’s history and risk factors for diseases, ensure that the patient’s medication list is up to date, and provide personalized health advice and counseling. The first AWV also allows the provider to establish a written personalized prevention plan. This new benefit will provide an ongoing focus on prevention that can be adapted as a beneficiary’s health needs change over time. Download a complete list of the AWV components here.
As a result of the Affordable Care Act, Medicare can now cover an Annual Wellness Visit (AWV), providing Personalized Prevention Plan Services (PPPS) at no cost to the beneficiary, so beneficiaries can work with their physicians to develop and update a personalized prevention plan. This new benefit will provide an ongoing focus on prevention that can be adapted as a beneficiary’s health needs change over time.
The first AWV providing PPPS is a one-time Medicare benefit and includes the following key elements furnished to an eligible beneficiary by a health professional:
- Establishment of the beneficiary’s medical/family history;
- Measurement of the beneficiary’s height, weight, body mass index, blood pressure, and other routine measurements as deemed appropriate, based on the beneficiary’s medical and family history;
- Establishment of a list of current providers and suppliers that are regularly involved in providing medical care to the beneficiary;
- Detection of any cognitive impairment that the beneficiary may have;
- Review of a beneficiary’s potential risk factors for depression;
- Review of the beneficiary’s functional ability and level of safety, based on direct observation of the beneficiary;
The Initial Preventive Physical Examination (IPPE)
In addition to the new AWV, Medicare also provides coverage for the Initial Preventive Physical Examination (IPPE), commonly known as the "Welcome to Medicare" Visit (WMV). Medicare has provided coverage for this exam since 2005; it is provided as a one-time service to newly-enrolled beneficiaries. The IPPE is an introduction to Medicare and covered benefits, with a focus on health promotion and disease detection.
The IPPE must be performed within the first 12 months after the beneficiary’s effective date of their Medicare Part B coverage. It contains a number of components that focus on prevention, including a complete medical/social/family history, a focused physical examination (ie. body mass index, blood pressure, visual acuity), an assessment of functional ability, and counseling.
To download a complete list of the IPPE components click here.
Important Note: Medicare provides coverage of the AWV and the IPPE as Medicare Part B benefits. The beneficiary will pay nothing for the AWV and the IPPE (there is no coinsurance or copayment and no Medicare Part B deductible for these benefits). To learn more about the AWV and the IPPE you can refer to Medicare Learning Network’s Guide to Medicare Preventive Services for Medicare Fee-For-Service Providers and Suppliers by clicking here.
Source: LEARNRESOURCE-L E-mail Update, National Institutes of Health, U.S. Department of Health and Human Services dated June 17, 2011
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