Once in a 12-month period. CMS says, "You can only bill G0438 or G0439 once in a 12-month period." G0438 is for the first AWV and G0439 for subsequent ones. CMS also says, "Don't bill G0438 or G0439 within 12 months of billing HCPCS code G0402 (IPPE) for the same patient."

First vs subsequent: G0438 and G0439

"G0438 is for the first AWV, and G0439 is for subsequent AWVs." (CMS, Annual Wellness Visit)

The 12-month rule

"You can only bill G0438 or G0439 once in a 12-month period." (CMS, Annual Wellness Visit)

The IPPE (G0402) rule

"Don't bill G0438 or G0439 within 12 months of billing HCPCS code G0402 (IPPE) for the same patient." (CMS, Annual Wellness Visit)

AWV plus a separate E/M service: modifier 25

"When you provide an AWV and a significant, separately identifiable, medically necessary evaluation and management (E/M) service, we may pay for the additional service. Report the additional CPT code (99202–99205, 99211–99215) with modifier 25. That portion of the visit must be medically necessary and reasonable to treat the patient's illness or injury or to improve the functioning of a malformed body part." (CMS, Annual Wellness Visit)

Desk checklist

This checklist is built from the CMS lines above, not extra CMS text:

  1. First AWV or subsequent? G0438 for the first, G0439 after that.
  2. Last AWV date: has it been 12 months since the last G0438 or G0439?
  3. Last IPPE date: has it been 12 months since G0402 for the same patient?
  4. Separate E/M? Only if it's significant, separately identifiable and medically necessary; report the E/M code with modifier 25.
  5. Check current CMS guidance and your MAC before billing.

FAQ

How often can you bill G0438 or G0439?

CMS says, "You can only bill G0438 or G0439 once in a 12-month period."

What's the difference between G0438 and G0439?

CMS says, "G0438 is for the first AWV, and G0439 is for subsequent AWVs."

Can you bill an AWV within 12 months of an IPPE?

No. CMS says, "Don't bill G0438 or G0439 within 12 months of billing HCPCS code G0402 (IPPE) for the same patient."

Can you bill an E/M visit on the same day as an AWV?

CMS says, "Report the additional CPT code (99202–99205, 99211–99215) with modifier 25." CMS adds, "That portion of the visit must be medically necessary and reasonable to treat the patient's illness or injury or to improve the functioning of a malformed body part."

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Source: CMS, Annual Wellness Visit (page last modified April 9, 2026; checked October 13, 2026). All quotes above are from this page.

This page is general information, not billing or legal advice.