Forum - Questions & Answers

Jan 30th, 2014 - sschwartz 4 

Annual Physicals male & female for Medicare patients

How do I bill for a patient visit in which an Annual Physical exam is done for a Medicare patient? I realize preventive physical codes 99381-99397 are not covered by Medicare; but I've also been told that Medicare's new AWE codes G0402, G0438 & G0439 are not actual physical exams wherein the provider examines the patient from head to toe and everywhere in between as it were. That they are more or less verbally going over medical issues and patient histories and setting up needed tests. What then is the correct method of billing an Annual Physical Exam with or without breast/pelivc or prostrate/rectal exams? I'm thoroughly confused and to make matters worse both our providers and patients seem to think annual physicals are the AWE's and expect them to be billed as such and therefore no copay or deductible being left for the patient; and we get outraged calls if they do.



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