Medicare Annual Wellness Visit

On March 8th, 2011, posted in: Industry News, Tips by

Don’t say ‘yippee’ yet, but CMS confirmed that local Medicare Contractors have the ability to determine if they will allow LPN’s and RN’s to perform annual wellness visits. That’s the scoop from the February 22nd CMS open door forum. The question was posed, “Can the LPN perform the entire annual wellness visit?” The answer:” YES, an RN or LPN can perform the visit. They need to be under the direct supervision of a physician and the state license needs to allow for them to do al the components of the service.” (www.wpsmedicare.com/part_b/education/awv-faq.shtml). The caller then asked “is this a general CMS policy or MAC specific?”

The reply: “Remember, the LPN’s not billing, said CMS’s William Rogers, MD, reminding the caller that the visit would be billed under the physician’s NPI incident-to”. He then went on to state “It’s a different sort of service; there’s not really any clinical judgment involved. It’s a service which includes a lot of administrative steps, verifying that people have made certain preventative services done and things like that, and so it is intended to be a collaborative service.”

So like I said, don’t yell ‘yippee’ yet. The Medicare carriers which serve PMA clients have not yet announced if they will agree with this determination. But if they do, it will certainly help take the burden of the extensive documentation from you.

What you need to remember, patients have been educated about this visit and they know the deductible and co-insurance amounts do not apply – they may request this service.