Preventative Care Wellness Visit Code

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

If you are treating patients specifically for the annual/preventative care physical please use the appropriate wellness visit code. If you are only performing a ‘preventative care’ visit some carriers (Amerihealth and BS Alabama) now what the modifier ‘33’ appended to the claim.


Commercial Carriers

G0438 – 1st annual visit

99365    18-39 years

99367    65+ years

HOWEVER, if you are also providing a ‘medical’ service, you may bill and E/M 99201-99205 – 99212-99215 for the condition you are treating. We will append the appropriate modifier. Your job is to make sure you clearly indicate both services in your documentation.