AWV vs IPPE vs Subsequent AWV: G0402, G0438, G0439
The IPPE, initial AWV and subsequent AWV are different Medicare benefits. A new patient at your practice is not necessarily eligible for an initial AWV.
Verify benefit history
Check Part B enrollment and prior services before selecting G0402, G0438 or G0439. G0438 is not a yearly initial visit. Use CMS's exact interval rules and eligibility history.
Complete the required elements
Document the applicable assessment and prevention plan. An AWV is not a routine comprehensive physical exam.
Assess additional services individually
A distinct medically necessary problem E/M may be separately reportable with modifier 25. Other services need their own eligibility and billing checks; an AWV does not automatically support a stack of additional codes.
Update the G0136 workflow
For 2026, G0136 describes physical activity and nutrition assessment. Follow the current optional-AWV-element and modifier 33 instructions.
Related code pages
Sources and next steps
Source links checked 2026-09-23. RVUDoc editorial reference; not an independently certified coding review.
Educational reference, not billing or legal advice. Verify against payer contracts and your compliance team before claim submission. Last updated 2026-09-23.