AWV and Medical Necessity Extras

CodeCast | Medical Billing and Coding Insights

When auditing Annual Wellness Visits (AWV), is the concept still the same as preventive exams concerning modifier 25?

The AWV does not include managing medications or managing conditions. However, the rules need to see medical necessity for the E/M on the same date with a -25 modifier. Remember, patients do not have a share of cost of AWV’s so if you add an E/M it comes out of their pocket too.

Terry also adds more commentary for the audio-only Telehealth rules for 2025.

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