Corporate Compliance

Note: Medicare clarifies benefit for annual wellness visit, including personalized prevention plan services

Medicare Insider, March 1, 2011

Want to receive articles like this one in your inbox? Subscribe to Medicare Insider!

Editor’s note: Judith Kares, JD, CPC, regulatory specialist for HCPro, Inc., is the author of this week’s note from the instructor.

In two recent transmittals (and a related MLN Matters article) Medicare clarified its new benefit for an annual wellness visit (AWV), including personalized prevention plan services (PPPS).  The threshold coverage requirement for most Medicare services is that they be “reasonable and necessary [medically necessary] for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.”  As a result, initially, Medicare did not cover any preventive services, as they were not viewed as being “medically necessary.”  However, over time, Medicare has conceded the value of preventive care and has begun to provide more and more preventive services and to remove barriers to beneficiaries’ receiving those services.

Continue reading Judith's note on the MedicareMentor Blog.



Want to receive articles like this one in your inbox? Subscribe to Medicare Insider!

Most Popular