P F
1 Out, 2019

Initial annual wellness examination for BlueCHiP for Medicare members

It is incorrect coding to file for depression screening (G0444) with the annual wellness visit for BlueCHiP for Medicare members. A depression screening should instead be filed with the initial visit (G0438). G0438 includes a depression screening by standardized instrument and includes an assessment of functional ability and level of safety. G0444 will not be reimbursed if filed on the same date of service by the same provider as G0438. Members may also not be billed.

The annual wellness visit, subsequent visit (G0439) does not include the requirements for the depression screening or the assessment of functional ability and level of safety, so G0444 will be reimbursed if performed and documented with the G0439.

If an annual wellness visit (G0438 or G0429) and an annual physical exam* (99385-99387 or 99395-99397) are performed on the same date of service by a primary care physician (PCP), physician assistant (PA) or nurse practitioner (NP), the documentation in the members medical record must reflect that the requirements for use of both codes are met. Please refer to the Preventive Services for BlueCHiP for Medicare Members Policy by clicking here.

*The Annual Physical Exam is not considered a preventive service. Please refer to the member’s EOC for applicable benefits for this service.