Often regarded as a necessity in maintaining top health, annual wellness visits (AWVs) have been a staple for most American households.

Mostly availed by those that possess personalized prevention plans, these checkups offer a detailed assessment that ensures household members are cleared of potential health problems. In recent years, the rates at which AWVs are carried out in the USA have grown considerably because of an increasing trend of health-consciousness, even more so considering the rise in health scares within the past few months.

While AWVs have many benefits involved, there’s one inquiry shared by many that don’t have an answer that’s as straightforward: Who is eligible to provide medicare-provided AWVs to beneficiaries?

If you’re a regular beneficiary of this program from a primary care provider (PCP) that you’re familiar with, then you may think that the PCP themselves are the only ones eligible. The truth, however, is that the answer is far more complex than you may expect because of all the intricacies and other pertinent details involved.

To answer the question as best as possible, let’s go over everything you need to know so that you can arrive at an appropriate answer that will satisfy your curiosities:

Understanding the difference between “perform” and “provide”

First, it is vital to understand that you may be at risk of confusing two important details when answering the question: the act of performing and the act of providing.

As interchangeable as they may seem at first, these two concepts pertain to completely different aspects of the entire AWV as they each refer to specific functions that may or may not be limited in nature. Performing annual wellness visits pertains to the ability of a party conducting the procedure on a patient under the general supervision of an accredited and licensed provider.

In terms of the question involved, however, the aspect that we’ll need to focus on is the party that operates as the actual billing provider of the AWV as it is what the concept of “providing” pertains to. 

Who is eligible to provide a medicare AMV to a beneficiary?


The American healthcare system grants the privilege or authority to provide AWVs to many trained professionals and providers. A few examples of these certified and permitted parties are:

1. Nurse practitioners and clinical nurse specialists

When it comes to providing medicare annual wellness visits, the CMS has paid a great deal of attention and trust to clinical nurse specialists and nurse practitioners. Thanks to the positive data and research behind the effectiveness of nurse-driven AWV programs, trained nurses are allowed to facilitate their own processes and provide services for US patients.

2. Urgent care providers

Apart from dealing with broken bones, infections, blood tests, and vaccinations, urgent care providers also possess the authority to provide and oversee medicare AWV. This has resulted in a growing number of urgent care centers providing such a service!

3. Telehealth providers

Despite the relatively-new image they bear, telehealth providers have been entrusted by the CMS because of the stringency that they offer and the strict standards they abide by. Certain service providers have wasted no time in adopting the service because of its availability and adaptability to their standard range of pre-existing service scope.

Conclusion

With a growing market for medicare annual wellness visits on American soil every year, there is an invaluable opportunity for healthcare providers to capitalize on the demand. Nevertheless, it’s vital to check whether or not you’re eligible to follow suit. By taking note of this guide, you can plan accordingly and scale your scope of services right away without any potential pitfalls!

When it comes to annual wellness visits, value-based programs, and remote patient monitoring, there’s no need to worry because we’ve got you covered with our services. Get in touch with us!

Get In Touch With Us

Our dedicated team is here to work with you and support you with our programs.

Patients

Providers

Partnerships

Copyright © 2019 Medistics LLC. All rights reserved.