Care Management Blog

Annual Wellness Visits (AWV) can be an effective way to embrace value-based care, so it’s important to understand the program's rules and regulations, as well as the different types of AWVs your practice can offer.

Understanding the billing codes for Medicare Annual Wellness Visits (AWVs) can provide a better idea of what is expected, both by the patient and by the payer. Understanding billing codes may also help you project revenues and optimize your staff’s capacity.

The Centers for Medicare & Medicaid Services (CMS) announced key reimbursement rates, additional CPT codes, two program expansions, and an entirely new care management program, effective January 1, 2023.

According to the American Journal of Accountable Care, only 24 percent of eligible beneficiaries receive and complete a Medicare Annual Wellness Visit (AWV). Studies have linked AWV participation to improved preventive care, cost savings, and revenue generation, but most ACOs have been slow to adopt them as a common practice. 

Value-based care requires providers to meet specific quality performance metrics. Failure to do so can negatively impact financial reimbursements and disappoint patient expectations. But even with these penalties, some organizations struggle to adopt this approach to primary care, as the course to do so isn't always straightforward.

Annual Wellness Visits (AWV) can be an important tool in preventive health. A vital component of an AWV is a Health Risk Assessment (HRA).

Advance Care Planning (ACP), or end-of-life planning, is a difficult task to undertake. It may involve uncomfortable conversations that are not always top of mind.

Without software, Annual Wellness Visits (AWV) will be difficult to provide to your patients. Your practice or organization will need to leverage a digital care coordination solution to implement your program and efficiency screen patients. 

Reimbursement rates for Annual Wellness Visits (AWV) are tied to the program’s Current Procedural Terminology (CPT) codes. These codes help categorize and specify billing rules and requirements for the procedures, treatments, and care services related to AWVs. 

Implementing value-based care can help providers improve patient health and reduce care costs, but it has introduced new, overwhelming challenges to physician practices.