Page 275 - Medicare Benefit Policy Manual

Subsequent AWV providing PPPS: The provision of the following services to an
eligible beneficiary by a health professional that include, and take into account the results
of an updated health risk assessment, as those terms are defined in this section:

a. Review (and administration if needed) of an updated health risk assessment (as
defined in this section).

b. An update of the individual’s medical/family history.

c. An update of the list of current providers and suppliers that are regularly
involved in providing medical care to the individual, as that list was developed for
the first AWV providing PPPS or the previous subsequent AWV providing PPPS.

d. Measurement of an individual’s weight (or waist circumference), BP, and
other routine measurements as deemed appropriate, based on the individual’s
medical/family history.

e. Detection of any cognitive impairment that the individual may have as defined
in this section.

f. An update to the following:

(1) The written screening schedule for the individual as that schedule is
defined in this section, that was developed at the first AWV providing PPPS,
and,

(2) The list of risk factors and conditions for which primary, secondary, or
tertiary interventions are recommended or are under way for the individual, as
that list was developed at the first AWV providing PPPS or the previous
subsequent AWV providing PPPS.

g. Furnishing of personalized health advice to the individual and a referral, as
appropriate, to health education or preventive counseling services or programs as
that advice and related services are defined for the first AWV providing PPPS.

h. Any other element determined appropriate by the Secretary through the NCD
process.

See Pub. 100-04, Medicare Claims Processing Manual, chapter 18, section 140, for
detailed claims processing and billing instructions.

280.5.1 – Advance Care Planning (ACP) Furnished as an Optional
Element with an Annual Wellness Visit (AWV) Upon Agreement with
the Patient
(Rev. 216 Issued: 12-22-15, Effective: 01-01-16, Implementation: 01-04-16)