If someone has already billed the G0438 code for this patient, it cannot be used again, and it must be used only after a patient has had Medicare for more than a year. If it is the patients first year in Medicare and they have never had a wellness visit you can use code G0402. This is the welcome to Medicare Wellness visit.
After both G0402 and G0438 have been used, use the G0439 code which is for subsequent visits after a year has passed since the last G0438 code has been used. This is the welcome to Medicare Wellness visit.
Below is the artical I found.
G0438 Annual Wellness Visit, Initial (AWV)
Annual wellness visit, including a personalized prevention plan of service (PPPS), first visit.
G0439 Annual Wellness Visit, Subsequent (AWV)
Annual Wellness visit, including a personalized prevention plan of service (PPPS), subsequent visit. Annual Wellness Visits can be for either new or established patients as the code does not differentiate. The initial AWV, G0438, is performed on patients that have been enrolled with Medicare for more than one year.
A patient is eligible for their subsequent AWV, G0439, one year after their initial visit. Remember that during the first year a patient has enrolled with Medicare the patient is eligible for the Welcome to Medicare visit or IPPE, Initial Preventative Physical Exam. This exam is billed using HCPCS code G0402. An Annual Wellness Visit code of G0438 should not be used and will be denied since the patient is eligible for the Welcome to Medicare visit during the first year of enrollment. For more information on the Welcome to Medicare visit go to CMS
