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AWV · Service Detail

Every eligible patient, reminded, scheduled, and screened on time

Eligibility verification, automated outreach, structured health-risk assessments, and checklist-driven compliance so no Medicare patient's Annual Wellness Visit slips through the cracks.

HCPCS G0438HCPCS G0439
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What It Is

The Annual Wellness Visit is a no-cost-to-patient Medicare benefit focused on a personalized prevention plan, health-risk assessment, and cognitive screening — distinct from a physical exam. It's also one of the highest-leverage visits a practice can run, since it opens the door to identifying candidates for CCM, RPM, APCM, and other programs in the same appointment.

The operational challenge is volume and timing: tracking exactly which patients are eligible for an initial vs. subsequent AWV, reminding them before their eligibility window closes, and making sure the visit checklist is complete enough to support the billing code.

What's included

  • Eligibility verification by patient & visit type
  • Automated reminder & scheduling outreach
  • Health-risk assessment & questionnaire preparation
  • Checklist-driven visit-completeness tracking
  • Identification of candidates for CCM/RPM/APCM during the visit
  • Documentation support for correct code selection
Who Qualifies
  • Patient is enrolled in Medicare Part B
  • At least 12 months have passed since enrollment (initial AWV) or the prior AWV (subsequent)
  • Visit includes the required health-risk assessment & personalized prevention plan
  • No other AWV billed by any provider in the qualifying period
Eligibility is confirmed by your clinical team — Elixir verifies documentation, not medical necessity.
CodeDescription
G0438Initial Annual Wellness Visit
G0439Subsequent Annual Wellness Visit
Common Questions

Annual Wellness Visits, answered plainly

Does the AWV replace a physical exam?+
No — it's a distinct, no-cost preventive benefit focused on risk assessment and prevention planning, not a hands-on physical. Practices often schedule both in the same visit for patient convenience, billed separately.
How do you avoid duplicate AWV billing?+
We verify Medicare's records for any AWV already billed elsewhere in the qualifying period before scheduling, which prevents a denied claim and a wasted visit slot.
Can this feed our other care-management programs?+
Yes — the AWV is one of the best entry points to identify patients who qualify for CCM, RPM, or APCM, and we flag those candidates directly from the visit data.
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Next Step

See AWV modeled on your own patient panel

Bring your panel size and payer mix to a 60-minute opportunity session and leave with a specific, numbers-based program design.

Book the Session info@elixirhc.com

Session Agenda

  1. Patient population & payer mix
  2. Current AWV activity, if any
  3. EHR & documentation workflow
  4. Staffing & device strategy
  5. Pilot design for this service
  6. Your clinic-specific opportunity model