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Update Pub. 100-04, Medicare Claims Processing Manual, Chapter 12, Section Concerning Healthcare Common Procedure Coding System (HCPCS) Billing Codes and Chapter 12, Section 30.6.2 Concerning Advance Beneficiary Notice of Non-coverage (ABN)…

The purpose of this Change Request (CR) is to update the HCPCS code billing section and the Advance Beneficiary Notice of Non-coverage (ABN) section 30.6.2 in Chapter 12 of Pub. 100-04, Medicare Claims Processing Manual concerning the Initial Preventive Physical Examination (IPPE) and Annual Wellness Visit (AWV) services. These updates clarify the billing code requirements for the IPPE and the AWV and provide additional ABN guidance.

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

Issue Date: March 14, 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.