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Annual Wellness Visit

Medicare Annual Wellness Visit is fully covered by Medicare as a preventative visit. These annual visits are different from annual physical exams, in that they are mainly a conversation about your overall health and priorities.

Moving forward, Princeton Medical Group will schedule your Medicare Annual Wellness Visit or AWV.

During the course of your AWV, your provider may discover and need to investigate or treat a new or existing problem. This additional care is considered diagnostic, meaning your provider is treating you because of certain symptoms or risk factors. Princeton Medical Group may bill you for any diagnostic care you receive during a preventive visit.

During your AWV, your provider can refill any medications currently prescribed to you and order relevant labs for review at a future visit. If you have a new medical condition or are in need of another acute service, you may incur a bill for those services.

Our goal for the visit will be to create a healthcare plan that makes sense for you, discuss any major concerns you may have with your well-being, and focus on what matters most to you with your healthcare.

If you do not already have an appointment for an AWV, please call our office at 609.924.9300 to schedule your appointment. To make the best use of your time during the visit, please be ready to discuss or have ready:

  • Your family health history
  • A list of other doctors you have seen in the last five years
  • Please bring all medications, vitamins, and supplements you are currently taking
  • Any health concerns or your priorities for the future

If you have any new or urgent health concerns prior to your appointment, please call our practice to let us know before your scheduled visit or when you check in.

Medicare regulations require us to bill patients for services beyond the scope included in the AWV. Therefore a separate appointment may be preferable to give you the necessary attention.

The Health Risk Assessment (HRA) form is also available on our website. Please complete it so your doctor can review it with you during your AWV.

Frequently Asked Questions

Is AWV the same as a yearly Physical?

No. This is a preventative visit guided by the Health Risk Assessment (HRA). It is a conversation to review potential risks identified by the questionnaire. It allows the provider and patient to come up with a plan for the coming year and update the chart to reflect other providers the patient is seeing. This is meant to encourage self-management between office visits. The goal is to identify potential problems and develop a plan to allow patient to improve quality of life, keep the patient independent and avoid unnecessary hospital or emergency room visits.

What is the Health Risk Assessment (HRA)?

This is a questionnaire that is to be completed by the patient prior to their AWV appointment. It asks basic questions about your current health status. It also allows the patient to advise their provider about changes, like medications, recent hospital or emergency room visits. It is very important to take the time to complete the document in full.  This form is available on Princeton Medical Group’s website under the Specialties menu. Please open the Annual Wellness Visit page.

Is there a Copay for AWV?

No. This is a covered service once every 365 days. Screening services that are part of the AWV are covered at 100%. However, if complex medical problems are identified and need to be addressed at the time of the visit that can end up requiring additional billing.

What if the patient has a specific health concern they would like to discuss?

It might be best to schedule a separate visit to talk about this. Per Medicare billing requirements and depending upon the complexity of the problem, specific health conditions we treat during the AWV may result in an extra charge.

What should the patient bring to the AWV?

The completed HRA form, any medical records since the last AWV (including immunization records), a family health history, list of medications (including OTC, vitamins, supplements or herbs) and a list of all the healthcare providers involved in their care.

Is Advanced Care Planning required as part of the AWV?

Advance Care Planning (ACP) is the process of making your long-term health care plans known and documented in case of an illness or accident that will not allow you to make decisions about your care. While this is not an easy conversation, it can bring peace of mind knowing that your long-term health goals are known and in place in case of emergency situations. This is not required but this is a common conversation that comes up as part of the AWV. Medicare will waive the copay, coinsurance or any deductible associated with this service if it is completed during the AWV.

Can Labs be done at the AWV?

Yes, but these are a separate service from the AWV and subject to usual insurance coverage. They are not covered any differently because they are completed with the AWV.

What if the patient has a Medicare Advantage insurance policy?

It would be beneficial to clarify the type of annual exam your insurance will cover.  All types of Medicare insurance provide coverage for an Annual Wellness Visit (AWV). Certain Medicare Advantage plans will cover a traditional yearly Physical Exam in addition to your AWV.

The most definitive answers will be provided by your insurance carrier. Contact your insurance provider to ask them if a yearly physical is covered. Insurance companies use special codes to identify types of services. Providing these codes may get you a clearer answer: 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397.