After a Medicare patient has had their Initial AWV (G0438), all future wellness visits are billed using G0439. Denials on this code almost always stem from frequency violations.
The Strict 11-Full-Month Rule
G0439 can only be billed once every 12 months. However, Medicare strictly defines this as "11 full months must have passed since the last AWV." If the patient had their last AWV on October 15, they are not eligible for their next G0439 until October 1 of the following year.
| Code | Description | Frequency Limit |
|---|---|---|
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (PPS), subsequent visit | Once every 12 months |
Documentation Requirements
Unlike the initial visit, G0439 requires you to update the patient's existing Health Risk Assessment (HRA), update their list of providers, and update their screening schedule. Standard preventive diagnoses (e.g., Z00.00) apply.
NCCI and Add-On Codes
G0439 is frequently billed alongside add-on preventive codes, such as Advance Care Planning (99497) or Depression Screening (G0444). Check NCCI edits to ensure proper modifier usage if a sick visit is also performed.