Coding & Compliance - October 2010
“Medicare To Cover New Annual Wellness Visits in 2010”
The Affordable Care Act (ACA) adds coverage for a new "Wellness Visit" and eliminates cost sharing for almost all of the preventive services covered by Medicare, effective January 1, 2011.
Medicare will cover a new annual wellness visit and will provide payment for the creation of a personalized prevention plan.
The wellness visit will have to include a health risk assessment to:
- Establish or update the patient's medical and family history
- Create a list of current providers and suppliers involved in providing medical care, including a list of prescriptions
- Take measurements of height, weight, body mass index, blood pressure, and other routine measurements, and detect cognitive impairments
- Review with the patient identified risk factors
- Create and update a written screening schedule, in the form of a checklist for the next 5-10 years
- If appropriate, refer the patient to health education or nutritional education programs
- At the initial wellness visit, the patient should be screened for depression, hearing loss, fall risk, home safety issures, and the ability to perform activities of daily living
If the proposed rule stands, Medicare will pay 100% of the allowable charge without patient co-pays or deductibles.
Medicare will also continue to pay for the "Welcome to Medicare" visit with the existing code G0402 ($136.80). If a patient receives a Welcome to Medicare visit they are not eligible for the initial annual wellness visit for 12 months. A patient must also wait 12 months after their Part B coverage is effective before being eligible for the inital wellness visit.
This is a great opportunity for a primary care practice to provide excellent patient care, customer service, and increase revenues.
If you have any questions or need additional information regarding this article, please contact Cindy Tipton-Cain at Cindy_Cain@MED3000.com
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