My practice has never billed for the Medicare Annual Wellness Visit and one of our providers was told by another provider in our community that they bill for the annual wellness visit AND the a physical (using an E/M office code) on the same day with mod.-25.
Medicare Annual Wellness Visit
Per the Medicare Learning Network article ICN 905706 January 2014 FAQs:
Can I bill a seperate E/M service st the same time as the AWV?
"Medicare may pay for a significant, seperately identifiable, medically necessary E/M service you bill at the same time as the AWV with modifier -25.
That portion of the visit must by medically necessary to treat the beneficiary's illness or injury, or to improve the functioning of a malformed body member."
I would interpret this as "NO", only an acute visit would be billable when medically necessary. A physical would not fall into this scope. Does anyone else agree??
Medicare Annual Wellness Visit
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