G0402
Initial preventive exam
Initial Preventive Physical Examination (IPPE), commonly called the "Welcome to Medicare" visit. CMS 2026 wRVU 2.43. One-time benefit per beneficiary, performed within the first 12 months of Medicare Part B enrollment. If missed, the patient skips directly to G0438 (initial AWV) after the IPPE window closes.
IPPE (G0402), initial AWV (G0438), and subsequent AWV (G0439) are three different Medicare preventive visits. Here is the decision tree and the timing rules.
Billing guidance for G0402 is locked
- When to use it: the exact clinical situations that support billing G0402
- Documentation checklist: the 8 elements your note needs before submitting
- Common pitfalls: the 6 mistakes that get G0402 downcoded or denied
Payer notes
Medicare covers G0402 with no patient cost share. Medicare Advantage plans follow but may use proprietary G-codes for some preventive components. Commercial payers do not pay G0402. If the patient's IPPE eligibility window has expired, document that fact and proceed with G0438 instead. EHR billing systems should flag the IPPE eligibility window automatically; if not, the practice should maintain its own tracker.