G0402
Initial preventive exam
Initial Preventive Physical Examination (IPPE), commonly called the "Welcome to Medicare" visit. 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.
Published by RVUDoc. Numeric data: CMS RVU26C, effective 2026-07-01. Page updated 2026-09-23. Calculation limits and editorial policy.
Fee-schedule estimate before claim adjustments. Coverage, setting and payer rules still apply.
Distinguish IPPE, initial AWV and subsequent AWV eligibility, frequency limits and requirements for additional same-day services.
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.
Related codes
These include alternative services and possible add-ons. Listing codes together does not establish that they can be billed together; check the applicable edits and payer policy.
See what G0402 adds to your year
Add it to the wRVU calculator with your own volume, or paste a note and let the chart audit check your coding.