G0438
Medicare WellnessCMS status: AAnnual Wellness Visit, initial visit. Medicare Part B preventive benefit for the first AWV after IPPE eligibility ends.
Work RVU
2.60
Practice RVU
2.45
Malpractice RVU
0.17
Total RVU
5.22
2026 Medicare payment
$174.35
National GPCI = 1.000 · Conversion factor $33.4009 · Non-facility
Model this code
Drop G0438 into a scenario to see how unit volume rolls up to annual wRVUs, gross collections, and bonus.
Open in calculator →When to use it
First AWV for a Medicare beneficiary who is past the 12-month IPPE window. Once per lifetime.
Documentation checklist
- ✓Health Risk Assessment.
- ✓Personal and family history review.
- ✓Functional ability and safety review.
- ✓List of current providers and meds.
- ✓Cognitive assessment (validated screen).
- ✓Depression screen (validated tool).
- ✓Vital signs including BMI.
- ✓Personalized prevention plan and schedule.
Common pitfalls
- !Billing G0438 for a patient who has had a prior AWV — should be G0439 from year 2 onward.
- !Adding 99214 without modifier 25 when a separate problem-oriented visit was performed.
- !Forgetting same-day add-ons (G0444, G0537, 99497).
Common modifiers
25 (on the problem-oriented E/M)
Common ICD-10 pairings
Z00.00
Pairs well with
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.