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Medicare AdvantageAdministrativeMedium impact

The Annual Wellness Visit: Preventive Care for Your Medicare Advantage Patients

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

Summary

Florida Blue provides updated guidance on Annual Wellness Visit (AWV) coding and quality measures for Medicare Advantage patients. The policy emphasizes proper use of HCPCS codes G0402, G0438, and G0439 for different AWV scenarios and highlights key HEDIS quality measures to incorporate during visits.

Action Required

Action needed
Immediately: Billing team should review AWV coding practices to ensure correct use of G0402 for initial Medicare visits (first 12 months), G0438 for first AWV (after 12 months), and G0439 for subsequent AWVs. Providers should adopt consistent AWV templates incorporating HEDIS quality measures (immunizations, cancer screenings, blood pressure control, advance care planning). Access Provider Portal through Availity Essentials to identify HCC and quality measure opportunities for scheduled patients.

Affected Billing Codes

G0402
G0438
G0439