Annual Wellness Visits (AWVs) go beyond a yearly evaluation. The AWV provides a means to achieving several goals, including:
- Ensuring patients receive standards-based preventive care
- Identifying current and potential health and safety risks
- Enhancing patient engagement and rapport
- Achieving higher care quality performance
The initial AWV sets the stage for better chronic disease management.
Care teams can use digital platforms to make AWVs highly efficient, and then use the results to connect patients with preventive care services. This has downstream benefits by supporting better outcomes, enabling cost savings, and promoting additional reimbursement.
Capturing the value of initial and subsequent AWVs
Initial and Subsequent Annual Wellness Visits focus on creating a personalized, longitudinal preventive care plan. These counsel patients on the value of assessing risk and proactively managing those risks.
Providers benefit from a standards-based AWV through:
- Achieving pay-for-performance quality measures
- Meeting Medicare Shared Savings Program requirements
- Generating revenue from the Initial and Subsequent AWVs
- Creating a revenue stream through appropriate screenings, tests, vaccinations and internal referrals
The American Academy of Family Physicians (AAFP) outlined examples of real-world patient AWVs and the type of potential RVU totals generated. Extrapolating from these two scenarios, annual revenue from 500 AWVs similar to these could provide more than $136,000 in new services.
Patient 1: Initial AWV with a 67-year-old male who has been diagnosed with hypertension and dyslipidemia. In this example, the visit would generate an estimated 5.18 RVUs based on the 2025 Final Rule.
Patient 2: Initial AWV with a 77-year-old female diagnosed with diabetes, hypertension, peripheral neuropathy, glaucoma, mild major depression, anxiety and COPD. In this example, the visit would generate an estimated 6.51 RVUs based on the 2025 Final Rule.
Figures 1 & 2: Real-world AWV coding examples with possible RVU totals. Source.
Subsequent AWVs at a similar scale and complexity could produce more than $64,000 in income each year. This doesn’t account for revenue from appropriate optional services, such as Advance Care Planning, SDOH risk assessment and other vaccines, assessments and counseling services.
A case study published in Family Practice Management shared best practices for this approach. It demonstrated how one provider tripled its AWV completion rate. They generated nearly $60,000 in Initial AWV revenue and expected another $17,000 in Subsequent AWVs, not including other services.
Creating this standardized and consistent AWV service sets the foundation for additional value-added care management programs.
Optimizing AWV value through care management program enrollment
The Annual Wellness Visit focuses on preventive care standards and personalized risk assessments.
Patients who have one or more chronic medical or behavioral conditions are at higher risk of worsening health and comorbidities. The AWV is an ideal time to introduce the value of Medicare care management programs. CMS estimates these services could benefit 70% of Medicare beneficiaries with two or more chronic conditions.
Whether during the AWV or in a follow-up visit, enrolling patients in medically necessary care management is another way to provide valuable longitudinal coordination.
Those care management programs include:
- Principal Care Management
- Chronic Care Management
- Remote Patient Monitoring
- Behavioral Health Integration
AWVs and care management enrollment go hand-in-hand.
This supports proactive wellness while helping patients achieve better disease and self-management. Additionally, it can help avoid exacerbations and reduce their need for inpatient or emergency care.
For providers, the symbiosis between the two supports care quality performance improvement and achieving value-based rewards.
ThoroughCare enables care management operations
Our platform provides a complete workflow for Annual Wellness Visits, assisting with CMS rules, tracking activities and making billing easier. In addition to AWVs, ThoroughCare offers care management modules for PCM, CCM, RPM and others, such as Transitional Care Management and Advance Care Planning.
Every module gives the care team instant access to enroll patients into new programs and begin using powerful features that make care management seamless, including:
- Guided workflows
- Evidence-based assessments
- Integrated CMS requirements
- Standards-based activities
- EHR integration with enhanced date tracking for AWV and other deadlines
- Seamless shared, team-based patient care activities
- Powerful data analytics, dashboards and reports
Key questions answered
How can providers maximize the value of Annual Wellness Visits?
After the Initial Annual Wellness Visit (AWV), patients can receive Subsequent AWVs for additional assessments and to update their preventive care plan.
Providers can create a standardized AWV program and enroll patients into appropriate Medicare care management programs. Combined, these programs can improve a patient’s current and long-term health, enhance quality measures and rewards and provide ongoing revenue.