3 steps to add annual Medicare wellness visits in your practice

Medicare now recognizes the important work that primary care physicians do when it comes to preventive screenings in older patients. So instead of only paying doctors for sick visits, the program will pay physicians to perform a preventive annual Medicare wellness visit (AWV).

But physicians should make some adjustments to their practices to ensure they adapt to what is the first of several Medicare changes intended to promote preventive care and improve care coordination and chronic disease management for Medicare patients.

The AMA STEPS Forward™ module “Medicare Annual Wellness Visit (AWV): Streamline Workflow to Perform a Thorough AWV” helps physicians understand the AWV, communicate with patients to set expectations about the visit and map out an AWV workflow.

The AMA’s STEPS Forward open-access modules offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These courses can help you prevent physician burnout, create the organizational foundation for joy in medicine and improve practice efficiency.

The AWV is a primary care visit that involves preventive care, advanced care planning and depression and dementia screening. It gives physicians a chance to focus on safety issues, such as falls, and social needs, such as food insecurity and transportation. Physicians and their teams can update information in a patient’s chart, such as a medication list, or they can create and maintain a personalized screening and prevention plan.

The Centers for Medicare and Medicaid Services (CMS) is recognizing that these visits help enhance a patient’s quality of life and that they are different from traditional “sick visits.” Identifying mental health concerns, cognitive impairments and other factors often involves in-depth conversations and non-face-to-face work. And physician offices can set up a system where all members of the care team contribute to the effort, maximizing patient benefit, practice pay and time savings.

Here are three steps to optimize annual wellness visits in your practice.

An annual wellness visit is different from the initial preventive physical examination, known as the IPPE. AWVs are offered to patients 12 months after they enroll in Medicare Part B and they are then covered once every 12 months.

Numerous components are part of the initial AWV, including screening for cognitive impairment and reviewing functional ability and level of safety. Nonphysician members of the care team can perform most of the components; the physician’s role is to synthesize the findings and provide recommendations. During subsequent visits, the information is reviewed and updated.

Make clear this visit is not the same as an annual physical and doesn’t include a physical exam. Medicare covers the AWV 100%, but any evaluation and management (E/M) work done during the visit is subject to copays, deductibles and coinsurance.

An AWV is covered only once every 12 months, so if a patient has had one elsewhere in that timeframe, they are not eligible for another one from your office.

First, physician offices will need to decide whether to combine AWV and problem-based visits. The STEPS Forward module then offers a sample process map as guidance on how to map out each step of the visit.

For example, if an office chooses to combine an AWV with E&M, the module outlines how to conduct and document the visit using both AWV and E&M templates.

The CME module, “Medicare Annual Wellness Visit (AWV) Streamline Workflow to Perform a Thorough AWV,” is enduring material and designated by the AMA for a maximum of 0.5 AMA PRA Category 1 Credit. 

The module is part of the AMA Ed Hub, an online platform with top-quality CME and education that supports the professional development needs of physicians and other health professionals. With topics relevant to you, it also offers an easy, streamlined way to find, take, track and report educational activities.

Learn more about AMA CME accreditation.