Preventive Medicare Services

Medicare preventive services — Annual Wellness Visits, screenings, immunizations, and counseling — represent significant untapped revenue for primary care practices.

By AJ Pakpour — The Business of Modern Medicine™

Educational Summary

Medicare covers a comprehensive range of preventive services — and most primary care practices are not capturing all the revenue available to them from these services.

The Annual Wellness Visit (AWV) is the centerpiece of Medicare preventive care. Unlike a traditional physical exam, the AWV focuses on health risk assessment, prevention planning, and care coordination. It is a distinct service with its own billing code and reimbursement — and it can be performed by qualified clinical staff under physician supervision.

Beyond the AWV, Medicare covers dozens of preventive screenings, immunizations, and counseling services — from colorectal cancer screening and mammography to diabetes prevention programs and tobacco cessation counseling. Each of these services has its own billing pathway.

For primary care practices, systematically identifying and delivering preventive services to eligible Medicare patients is both a clinical imperative and a revenue opportunity. Practices that build preventive care workflows — identifying eligible patients, scheduling appropriate services, and billing correctly — consistently generate more revenue per Medicare patient.

Key Takeaways

• ✓The Annual Wellness Visit (AWV) is a distinct Medicare service with its own billing code
• ✓AWV can be performed by qualified clinical staff under physician supervision
• ✓Medicare covers dozens of preventive screenings, immunizations, and counseling services
• ✓Systematic preventive care workflows significantly increase revenue per Medicare patient
• ✓Preventive services support quality metrics and value-based care performance