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Medicare AdvantageBilling CodesMedium impact

Coding Newsletter - Annual Wellness Visit

Florida Blue·FL · Family Medicine, Internal Medicine, General Practice +1 more·Coding
Effective date
Not stated
We identified it
Jun 16, 2026
Days to comply

Summary

Florida Blue updated Annual Wellness Visit coding guidelines, adding new optional Social Determinants of Health Risk Assessment (G0136) and clarifying documentation requirements for IPPE, initial AWV, and subsequent AWV visits. The policy reinforces frequency limits of one visit per calendar year and lifetime limits for IPPE and initial AWV across all providers.

Action Required

Action needed
Immediately: Update billing system to include optional SDOH Risk Assessment code G0136 (limited to every 6 months). Train providers on enhanced documentation requirements for AWV visits including mandatory cognitive assessments and 5-10 year screening schedules. Verify frequency edits are in place to prevent billing multiple AWV codes per calendar year across all providers to avoid 'Annual Wellness Visit Limit Exceeded' denials.

Affected Billing Codes

G0402
G0403
G0404
G0405
G0468
G0438
G0136
99497
99498
G0439
99385
99395
99386
99396
99387
99397
99214
Z00.00
Z00.01