G0402
Welcome to Medicare visit
The initial preventive physical examination. Available only within the first 12 months of Part B enrollment.
CPT Codes
Annual wellness visit codes: G0438, G0439 and G0402
Three codes covering two different services. The most common error is treating the Welcome to Medicare visit as an annual wellness visit.
G0438
Initial annual wellness visit
The first annual wellness visit, furnished after the first 12 months of Part B enrollment.
G0439
Subsequent annual wellness visit
Each annual wellness visit after the initial one, reportable once every 12 months.
The Common Error
Is the annual wellness visit a physical?
No. The annual wellness visit is not a head-to-toe physical examination. It is built around a health risk assessment and a personalized prevention plan, with only limited measurements taken.
The measurements are confined to items such as height, weight, body mass index and blood pressure. There is no requirement for the unclothed examination patients often expect, and setting that expectation early avoids a difficult conversation in the room.
Medicare does not cover a routine annual physical examination. Where a patient wants one, that is a separate, non covered service and needs to be explained as such before it is provided.
Sequencing
Which of the three codes applies?
It depends entirely on where the patient sits in their Part B enrollment. G0402 applies only in the first 12 months. G0438 is the first annual wellness visit after that. G0439 is every one thereafter.
The Welcome to Medicare visit and the annual wellness visit are different services, and treating them as interchangeable is the most frequent error in this family. A patient cannot receive both in the same 12 month period.
G0438 is reported once in a patient's lifetime. A practice inheriting a patient from another practice needs to establish whether an initial annual wellness visit has already been furnished, because reporting a second one will not stand.
Common Questions
Related questions
Is the annual wellness visit the same as a yearly physical?
No. Medicare does not cover a routine physical examination. The annual wellness visit centers on a health risk assessment and a personalized prevention plan, with limited measurements such as height, weight, body mass index and blood pressure.
What is G0402 for?
The Welcome to Medicare visit, formally the initial preventive physical examination. It is available only within the first 12 months of Part B enrollment, and it is a different service from the annual wellness visit.
How often can an annual wellness visit be reported?
Once every 12 months. The initial visit is reported with G0438 and each subsequent one with G0439. A patient cannot receive an annual wellness visit and a Welcome to Medicare visit within the same 12 month period.
Can G0438 be reported more than once for a patient?
No. The initial annual wellness visit is a once in a lifetime service. Where a patient transfers from another practice, establish whether an initial visit has already been furnished before reporting one.
Does the annual wellness visit include a cognitive assessment?
Yes. Detection of cognitive impairment is among the required elements, alongside the health risk assessment, a review of medical and family history, a list of current providers and suppliers, and the personalized prevention plan.
Code descriptors reflect the AMA CPT code set and the CMS HCPCS code set current as of CY2026. Both are revised annually, and Medicare Administrative Contractor and commercial payer policy varies. This page describes what each code covers and the conditions attached to reporting it. It is a reference, not billing advice for a specific claim, and it carries no payment rates.
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