Blue Cross and Blue Shield of North Carolina (Blue Cross NC) reminds providers that the Blue Medicare Advantage program covers one (1) Annual Wellness Visit (AWV), G0438/G0439, and one (1) Preventive Medicine Visit, 99381-99397, per calendar year for enrolled beneficiaries. 

These visits are a separate benefit from the initial Preventive Physical Exam (IPPE)/ ”Welcome To Medicare” visit, G0402, available in the first twelve (12) months that the member is enrolled in the Blue Cross NC Blue Medicare Advantage program.

After the member’s first year, benefits include an updated health risk assessment, update of the member’s medical and/or family history, measurement of weight, blood pressure and other routine measurements.

Member’s benefits cover one (1) AWV (Annual Wellness Visit) and one (1) Preventive Medicine Visit per calendar year by a licensed health professional.  If providers choose to perform both services together, they are encouraged to follow code issuer guidance with applicable diagnoses and modifiers.

For more information on Annual Wellness Visits and Preventive Physical Exams, please visit the following links:

• Medicare Claims Processing Manual (cms.gov)
• Evidence of Coverage
• Evaluation and Management Services MA