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WHICH REIMBURSEMENT PLAN IS BEST FOR YOU ?

 If your are a Single Provider Clinic, Larger Practice with 3 or more Providers we have an Medicare AWV or CCM solution for you. We can help optimize Practice Revenue, minimize Staff Time and improve MIPS reporting. The patient receives the optimum amount of cost neutral time with Healthcare professionals on your behalf. 

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Typical AWV Example 3 to 5 CPT Codes: G0438 + G0442 + G0446 + 99497 =  $305

“see additional Triggered Codes”

Additional AWV Triggered Codes (Partial list)

CPT combination will vary based on patient assessment

      Advance Care Planning

  • 99497 Advance Care Plan 30 min
  • 99498 Advance Care Plan additional 30
    Cardiovascular Disease Screening Blood Tests
  • 80061 - Lipid panel,  must include:
  • 82465 - Cholesterol, serum, total
  • 83718 - Lipoprotein, (HDL cholesterol)
  • 84478 - Triglycerides Counseling to Prevent Tobacco Use for Asymptomatic Beneficiaries
  • 99406 - Smoking and tobacco cessation counseling visit >3 to 10 min
  • 99407 - Smoking and tobacco cessation counseling visit >10 min
    Diabetes Screening Tests
  • 82947 - Glucose; quantitative, blood 
  • 82950 - Glucose; postglucose dose
    Diabetes Self-Management Training (DSMT)
  • G0108 - DSMT, individual, per 30 min
  • G0109 - DSMT, group (2 or more), per 30 min
    Intensive Behavioral Therapy (IBT) for Cardiovascular Disease “CVD risk reduction visit”
  • G0446 - Annual, face-to-face intensive behavioral therapy for cardiovascular disease, 15 minutes
    Intensive Behavioral Therapy (IBT) for Obesity
  • G0447 - Face-to-face behavioral counseling for obesity, 15 minutes
    Medical Nutrition Therapy (MNT)
  • 97802 - MNT; initial assessment and intervention, individual, faceto-face with the patient, each 15 minutes 
  • 97803 - MNT; re-assessment and intervention, individual, face-to-face with the patient each 15 minutes 
  • 97804 - MNT; group (2 or more individual(s)), each 30 minutes 
  • G0270 - MNT reassessment and subsequent intervention(s) for change in diagnosis, individual, each 15 minutes 
  • G0271 - MNT reassessment and subsequent intervention(s) for change in diagnosis, group (2 or more), each 30 minutes
    Screening and Behavioral Counseling Interventions in PCP to Reduce Alcohol Misuse
  • G0442 - Annual alcohol misuse screening, 15 minutes 
  • G0443 - Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes
    Screening for Depression
  • G0444 - Annual depression screening, 15 minutes
    Screening Pelvic Examinations
  • G0101 - Cervical or vaginal cancer screening; pelvic and clinical breast examination
  • G0445 - Semiannual high intensity behavioral counseling to prevent STIs, individual, face-to-face
  • 76706 - TC Abdominal Aortic Aneurysm Screening
    Influenza Virus Vaccine and Administration
  • 90673 - Influenza Virus Vaccine 
  • G0008 - Administration
    Pneumococcal Vaccine and Administration
  • 90670 - Pneumococcal Conjugate Vaccine 
  • 90732 - Pneumococcal polysaccharide vaccine 
  • G0009 - Administration
    Hepatitis B (HBV) Vaccine and Administration
  • 90740 - Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (3 dose schedule)
  • 90743 - Hepatitis B vaccine, adolescent (2 dose schedule)
  • 90744 - Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule)
  • 90746 - Hepatitis B vaccine, adult dosage (3 dose schedule)
  • 90747 - Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (4 dose schedule)
  • G0010 - Administration
    Prostate Cancer Screening
  • G0102 - Digital Rectal Exam (DRE) 
  • G0103 - Prostate Specific Antigen Test (PSA)

AWV G0438 & G0439 Typical Billing Examples

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who can perform an AWV ?

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 Go to Downloads for a printable PDF 

Practice revenue "projection" forcast per 100 patients

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 Go to Downloads for a printable PDF 

to get started - do the following

1) Identify eligible Medicare patients

Go to the download section of the site and download the "New Practice Information Form" and "the appropriate BAA agreement". Send completed - signed documents and EMR login credentials via email to david@medicare-network.org  


I will work with the  appropriate AWV/CCM service company to establish eligibility of your Medicare and Medicare Advantage Patients and send you a Practice Revenue "Projection" Forecast based on eligibility.

2) Review the Practice Revenue "Projection" Forecast expectations and select one the plans that will work best for your Practice.

We will wait to here from you.  

If you decide you do not want to use our services there is no cost for anything we have done.

3) Call me to discuss your expectations and instruct us to move forward. We will send a final document confirming details we both must sign.

We will assist the practice in transferring patient information to the AWV/CCM software. We will schedule an onboarding meeting with all key players to discuss the AWV/CCM process , Patient Engagement, Scheduling Scheduling, clarify the roll of the CNA, CMA or RN , discuss Practice Work Flow Protocols, specify who and how the AWV details will be updated in the EMR, and who will prepare and send the bill to Medicare or Medicare Advantage Plans.