Monday, August 15, 2011

CPT G0438, G0439, G0389 - Medicare payment and frequency

Annual Wellness Visit (AWV)
This is a new benefit beginning for dates of service on and  after 01/01/11


CPT CODE


G0438 – First visit
G0439 – Subsequent visit

No specific diagnosis code Contact the local Medicare Contractor for guidance

All Medicare beneficiaries who are no longer within 12 months after the effective date of their first Medicare 


Part B coverage period and who have not received an IPPE or AWV within the past 12 months
Once in a lifetime for G0438
Annually for G0439

Medicare payment 
Prior to 01/01/11:
N/A
On or after 01/01/11:
Copayment/coinsurance waived
Deductible waived





Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)


CPT G0389 – Ultrasound exam AAA screen


No specific diagnosis code Contact the local Medicare Contractor for guidance


Medicare beneficiaries with certain risk factors for abdominal aortic aneurysm


Important – Eligible beneficiaries must receive a referral for an AAA ultrasound screening as a result of an IPPE


Once in a lifetime benefit per eligible beneficiary


Patient payment 


Prior to 01/01/11:
Copayment/coinsurance applies
Deductible waived
On or after 01/01/11:
Copayment/coinsurance waived
Deductible waived

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