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Reimbursement for Annual Wellness Visits Effective January 1, 2023

Audience: Primary Care and OB/GYN Physicians and Nurse Practitioners

We would like you to be aware of an upcoming change to our reimbursement policy regarding annual wellness visits.


Annual Wellness Visit codes G0438 and G0439, and Initial Preventive Physical Examination code G0402 are currently a covered benefit for Traditional Medicare and Medicare Advantage only.


Effective with dates of service on or after January 1, 2023, the Health Plan will no longer offer reimbursement for codes G0438, G0439, and G0402 non-Medicare lines business. These will be covered under the appropriate annual comprehensive preventive exam codes.


If you have questions, please contact your Provider Relations representative. Thank you for the service that you provide to our valued member.

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