What Preventitive Services Does Medicare Pay For

What are Medicare Preventive Visits?

Employ this toolkit to leverage best practices in implementing an almanac comprehensive visit plan within your healthcare practise. Please click hither to contact usa if you have any questions regarding any of these materials.

What is an AWV?

The Medicare Annual Wellness Visit (AWV) is an in-office visit enabling healthcare providers to develop a comprehensive motion-picture show of a patient'due south health risk, goals and barriers. Diagnostic components such as low screening and functional assessment help to design a personalized handling plan focused on patient wellness and preventive care.

What is an APPE/CPE?

The Almanac Preventive Physical Examination (APPE)/Comprehensive Physical Exam (CPE) is an in-office visit enabling healthcare providers to collect age and gender-advisable medical history, provide guidance on reducing healthcare risk factors, and order whatsoever laboratory or diagnostic procedures that may be required for patient intendance.

Information technology is important to annotation that an annual preventive physical examination is Humana Medicare Advantage programme benefit and is not covered by Original Medicare. The data provided on this website is intended to be applied merely to Humana Medicare Advantage members.

What is an Annual comprehensive visit?

An Annual comprehensive visit combines the Medicare AWV and the APPE/CPE into one visit for your patients.

Conducting a physical exam together with an AWV offers multiple benefits to you and your patients whose benefits include an APPE/CPE.

Patients may experience improved health outcomes and greater satisfaction with their medical care while saving time and money.

Patients may experience improved health outcomes and greater satisfaction with their medical care while saving time. Practices may see greater medication adherence and improved treatment compliance, in improver to improving quality measures such equally Healthcare Effectiveness Data Information Prepare (HEDIS®) and Stars. Statistics support the combining a physical exam with an AWV:ane

10% increase in Healthcare Effectiveness Data Information Prepare HEDIS® scores
9% increment in re-documentation of chronic conditions twelvemonth over twelvemonth
3% increase in follow-up clinical visit rates

1 The data is based on a Humana study conducted past the Intermountain Region (IMR) Idaho, Oregon, Utah, and Washington using year to date (YTD) claims for Electric current Procedural Terminology (CPT) codes—in this case after an annual comprehensive visit. IMR data used the re-documentation claims data from Jan. ane – November. five, 2018, CPT codes G0438 - G0439 and 99397 (or age-appropriate CPT code), to determine the recapture charge per unit and the quality pass rates for individuals who had an almanac comprehensive visit versus those who did not accept an AWV or preventive concrete visit. Clinical follow-upward after the comprehensive visit looked at members with CPT codes who had a follow-upward visit categorized by E/M codes or other identifying face up-to-face service, 99211– 99214 for example, to decide the percentage of members returning for a follow-upwards visit.