Annual Wellness Visit (AWV)
The Annual Wellness Visit is a Medicare-covered preventive service (G0438 initial, G0439 subsequent) that establishes or updates a personalized prevention plan and health risk assessment for Medicare beneficiaries — with no patient cost-sharing.
What is the Annual Wellness Visit?
The AWV is a Medicare Part B preventive benefit, not a physical exam. It requires a health risk assessment (HRA), review of the patient's medical and family history, a list of current providers and medications, measurement of height/weight/BMI/blood pressure, detection of cognitive impairment, establishment of a written screening schedule, and a personalized prevention plan. G0438 (initial AWV) reimburses approximately $180–220; G0439 (subsequent AWV) reimburses approximately $110–140. It cannot be billed within 12 months of a prior AWV, and the Welcome to Medicare Visit (G0402) is a separate, once-per-beneficiary service. Because no hands-on clinical assessment is required, the AWV can be conducted by an RN or medical assistant under physician supervision — enabling high-throughput, team-based delivery. Average practices with unscheduled eligible patients miss an estimated $2.1 million in AWV revenue annually.
Why It Matters for Healthcare Analytics
AWV completion is directly incentivized by Medicare Advantage plans and affects Star Ratings performance. Beyond direct revenue, the AWV encounter is an ideal opportunity to close care gaps (mammography, colorectal screening, depression screening), capture HCC diagnoses, and bill additional preventive services on the same date. Analytics should track eligible Medicare patients without an AWV in the past 12 months and prioritize scheduling outreach by risk tier.
How Vizier Tracks AWV
Upload your patient roster and claims data, then ask "Which Medicare patients are overdue for an Annual Wellness Visit?" — Vizier identifies the eligible gap population, estimates uncaptured revenue, and highlights co-schedulable preventive services to maximize each visit's value.