I did my first one of these today. The form from AAFP was very helpful. I did see this Medicare Learning Matters alert which makes it look like you can NOT bill a separate E&M visit on same day and get paid separately, even if you use the -25 modifier. I am going to play it safe and have them comeback on a separate day for the Annual Wellness visit (AWV).
MLN Matters
Information for Medicare Fee-for-Service Health Care Professionals
MLN Matters Number: MM7079 Revised
Related Change Request (CR) #: 7079
Related CR Release Date: February 15, 2011
Effective Date: January 1, 2011
Related CR Transmittal #: R138BP and R2159CP
Implementation Date: April 4, 2011
Annual Wellness Visit (AWV), Including Personalized Prevention Plan Services (PPPS)
Note: This article was revised on February 17, 2011, to reflect changes made to CR 7079. The changes made were the deletion of voluntary advance care planning as a specified element of the AWV, clarification that payment methodology for Types of Bill (TOB) 12X and 13X is based on the Medicare Physician Fee Schedule, and that for TOBs 71X and 77X, the AWV does not qualify for separate payment with another encounter. The CR transmittal numbers, CR release date, and the Web addresses for accessing CR 7079 have also changed. All other information remains the same.
