Clinical meaning
The Medicare Annual Wellness Visit (AWV) is a preventive service distinct from a routine physical exam — it focuses on health risk assessment, personalized prevention planning, and early detection rather than treatment of acute complaints. The Initial Preventive Physical Examination (IPPE or 'Welcome to Medicare' visit) is available within the first 12 months of Medicare Part B enrollment, while the AWV is available annually thereafter. The AWV framework is built on the Health Risk Assessment (HRA), a standardized questionnaire evaluating demographics, self-assessed health status, psychosocial risks (depression screening with PHQ-2/PHQ-9), behavioral risks (tobacco, alcohol, physical inactivity, diet), functional abilities and ADL/IADL limitations, and home safety. Cognitive assessment is a mandatory component — validated tools include the Mini-Cog (3-word recall + clock drawing), Montreal Cognitive Assessment (MoCA), or structured patient history. The clinician develops or updates a Written Screening Schedule based on USPSTF grade A and B recommendations individualized to the patient's age, sex, and risk factors. Advance care planning (ACP) is a separately billable component (CPT 99497) involving discussion of advance directives, healthcare proxy designation, and goals of care. The...