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MLN Matters Article MM13548: Medicare Claims Processing Manual Updates – HCPCS Billing Codes & Advance Beneficiary Notice of Non-coverage Requirements

This new Article comprises Subregulatory Guidance for using HCPCS codes G0402, G0438, and G0439 for billing initial preventive physical examination (IPPE) and annual wellness visit (AWV) services; not billing CPT codes 99381-99397 (comprehensive preventive medicine evaluation and management services) for IPPE and AWV services; and giving your patients an Advance Beneficiary Notice of Non-coverage (ABN) for certain preventive services. MLN Matters (MM) Articles are based on information contained within Change Requests (CRs). In this case, this article is based on content within CR13548 that is posted on the CMS website at https://www.cms.gov/files/document/r12546cp.pdf.

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: March 15, 2024

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.