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Traditional MedicareBilling CodesMedium impact

Do you have time for a Quality Minute about annual wellness visits?

BCBS Michigan·MI · Family Medicine, Internal Medicine, General Practice +1 more·Quality Measures
Effective date
Not stated
We identified it
Jun 16, 2026
Days to comply

Summary

This is guidance on Medicare annual wellness visits, emphasizing that practices can bill additional E/M services with modifier 25 on the same day as the wellness visit. The policy provides coding instructions for G0402, G0438, and G0439 and workflow recommendations to optimize billing and quality metrics.

Action Required

Action needed
Immediately: Billing team should implement workflow to bill E/M services with modifier 25 when provided on same day as annual wellness visits. Update billing software to prompt for modifier 25 with concurrent E/M services. Train staff on eligibility requirements and ensure documentation supports medical necessity for both the wellness visit and E/M service to avoid claim denials.

Affected Billing Codes

G0402
G0438
G0439
G0468
99202
99203
99204
99205
99211
99212
99213
99214
99215
99385
99386
99387
99391
99392
99393
99394
99395
99396
99397