May 2021
Preventive Services Reminder: Zero Copay for Blue Cross Medicare AdvantageSM
Are your patients up to date on preventive services benefits? BCBSTX would like to remind you that there are no copays for preventive services for Blue Cross Medicare Advantage (PPO)SM or Blue Cross Medicare Advantage (HMO)SM. Blue Cross Medicare Advantage covers a full range of preventive services to help keep patients healthy, help find problems early and determine when treatment is most effective. You should let members know which of these services is right for them.
Access the Centers for Medicare & Medicaid Services (CMS) Medicare Learning Network for detailed information on Medicare Preventive Services.
Additionally, you should check eligibility and benefits electronically through Availity® or your preferred web vendor.
Annual Health Assessment Coding*
Code** |
Service |
Description |
G0402 |
Initial Preventive Physical Examination |
Code is limited to new beneficiary during the first 12 months of Medicare enrollment. |
G0438 |
Initial Annual Wellness Visit (AWV) |
The initial AWV, G0438, is performed on patients who have been enrolled with Medicare for more than one year, including new or established patients. |
G0439 |
Subsequent AWV |
The subsequent AWV occurs one year after a patient’s initial visit. |
*Codes for Annual Health Assessments are subject to change by Medicare Advantage Organization (MAO), without prior notice to Medical Group, for codes to be consistent with Medicare coding requirements for Annual Health Assessments.
**Any updates, deletions and/or additions to coding shall be updated according to nationally recognized coding guidelines.