Forum - Questions & Answers

Apr 22nd, 2019 - staracres

Medicare Annual Wellness Visit in the Nursing Home Setting

Hello, I would like to know if long term care nursing home patients are eligible for the Medicare Annual Wellness visit. The POS code is 32 and E/M code G0439 (subsequent AWV code). I understand that nursing home codes allow for an annual nursing home assessment 99318 code. Please advise. Thanks in advance.

May 6th, 2019 - ChrisW   256  1 

re: Medicare Annual Wellness Visit in the Nursing Home Setting

I would check with the payer on the POS. I did however, find a Decision Health article dated 05/12/2014, Medicare preventive services OK in assisted living, nursing homes, “While home health agencies can’t provide an AWV or IPPE, an AWV is permitted in an assisted living facility (place of service 13) and a long-term care facility (POS 32)”.

Keep in mind the AWV is not the same as a physical or an E/M initial assessment, there are some restrictions and important information required for payment, I added a few resources.

- Remember preventative services should be reported with modifier –33 (Preventive Service) if applicable.
- Reminder per AMA Guidelines, “(Do not report 99318 on the same date of service as nursing facility services codes 99304-99316).”

Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2024 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association