{"id":16134,"date":"2022-12-22T14:07:29","date_gmt":"2022-12-22T14:07:29","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=16134"},"modified":"2026-10-05T18:17:24","modified_gmt":"2026-10-05T12:47:24","slug":"billing-medicare-for-initial-preventive-physical-examination","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/","title":{"rendered":"Billing Medicare for Initial Preventive Physical Examination"},"content":{"rendered":"\n<div class=\"wp-block-yoast-seo-ai-summarize yoast-ai-summarize\"><h2>Key Takeaways<\/h2>\n<ul class=\"wp-block-list yoast-ai-summarize-list\">\n<li>The Initial Preventive Physical Examination (IPPE) is a one-time preventive visit covered by Medicare within the first 12 months of Part B enrollment.<\/li>\n\n\n\n<li>Providers bill the IPPE using HCPCS code G0402 and can bill for additional services with codes 99202\u201399215 using modifier -25 if medically necessary.<\/li>\n\n\n\n<li>IPPE includes assessments of medical history, depression screening, functional ability, and other vital checks like height and weight measurements.<\/li>\n\n\n\n<li>Medicare does not require a specific diagnosis code for IPPE, but providers should choose one consistent with the exam.<\/li>\n\n\n\n<li>The IPPE is distinct from the Annual Wellness Visit (AWV), which is available after the first year of coverage.<\/li>\n<\/ul>\n<\/div>\n\n\n<h2><span style=\"font-weight: 400;\">Initial Preventive Physical Examination (IPPE)<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The initial preventive physical examination (IPPE) is a preventive visit also known as a \u2018Welcome to Medicare Preventive Visit\u2019. Medicare pays for one IPPE per beneficiary per lifetime for beneficiaries within the first 12 months of the effective date of the beneficiary\u2019s first Part B coverage period. The IPPE may be performed by a doctor of medicine or osteopathy or a qualified non-physician practitioner (nurse practitioner, physician assistant, or clinical nurse specialist). For practices that rely on <a href=\"https:\/\/www.medicalbillersandcoders.com\/speciality\/primary-care-medical-billing-services.html\"><strong>primary care billing services<\/strong><\/a>, billing this one-time visit correctly is key to capturing preventive care revenue.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The physician or qualified NPP shall bill HCPCS code G0402 for the IPPE performed face-to-face with the patient. The physician or entity shall bill HCPCS code G0403 for performing the complete screening electrocardiogram (EKG) that includes the tracing, interpretation, and report. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The physician or entity that performs the screening EKG tracing only (without interpretation and report) shall bill HCPCS code G0404. The physician or entity that performs the screening EKG interpretation and reports only, (without the EKG tracing) shall bill HCPCS code G0405.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Applicable HCPCS Codes for IPPE<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">While billing for IPPE, you must report a diagnosis code. Medicare won\u2019t require a specific IPPE diagnosis code, so you may choose any diagnosis code consistent with the patient\u2019s exam. This is where accurate <a href=\"https:\/\/www.medicalbillersandcoders.com\/medical-coding-services.aspx\"><strong>medical coding services<\/strong><\/a> help keep IPPE claims clean on first submission.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Medicare Part B covers an IPPE when performed by a physician (doctor of medicine or osteopathy) or qualified non-physician practitioner (NPP) (physician assistant [PA], nurse practitioner [NP], or certified clinical nurse specialist [CCNS]). <\/span><\/p>\n<p><span style=\"font-weight: 400;\">When you provide an IPPE and a significant, separately identifiable, medically necessary Evaluation and Management (E\/M) service, Medicare might pay for the additional service. Report the additional CPT code (99202\u201399215) with modifier -25. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">That portion of the visit must be medically necessary and reasonable to treat the patient\u2019s illness or injury or to improve the functioning of a malformed body part.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Related read: <a href=\"https:\/\/www.medicalbillersandcoders.com\/blog\/how-to-use-modifier-25-accurately-for-medicare\/\">How to Use Modifier 25 Accurately for Medicare<\/a> explains when a same-day E\/M service qualifies for separate payment.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You can use the following HCPCS codes to file IPPE and ECG screening claims:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">G0402 \u2013 IPPE is a face-to-face visit. Service is limited to a new beneficiary during the first 12 months of Medicare enrollment.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">G0403 \u2013 Electrocardiogram (ECG) performed as a screening for the IPPE (with interpretation and report).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">G0404 \u2013 ECG performed as a screening for the IPPE (tracing only without interpretation and report).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">G0405 \u2013 ECG performed as a screening for the IPPE (interpretation and report only).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">G0468: Federally Qualified Health Center (FQHC) visit, IPPE or AWV; an fQHC visit that includes an initial preventive physical examination (IPPE) or annual wellness visit (AWV) and includes a typical bundle of Medicare-covered services that would be furnished per diem to a patient receiving an IPPE or AWV.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The IPPE is often confused with the Annual Wellness Visit (AWV), which becomes available only after the first 12 months of Part B coverage. Our <a href=\"https:\/\/www.medicalbillersandcoders.com\/speciality\/family-practice-medical-billing-services.html\"><strong>family practice billing services<\/strong><\/a> team helps practices track the eligibility window for both visits.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Also read: <a href=\"https:\/\/www.medicalbillersandcoders.com\/blog\/family-practice-billing-in-illinois-annual-wellness-visit-optimization\/\">Family Practice Billing in Illinois: Annual Wellness Visit Optimization<\/a>.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Contents of Initial Preventive Physical Examination (IPPE)<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The Initial Preventive Physical Examination (IPPE) includes the following:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">review of the individual\u2019s medical and social history with attention to modifiable risk factors for disease detection,\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">review of the individual\u2019s potential (risk factors) for depression or other mood disorders,<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">review of the individual\u2019s functional ability and level of safety,\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">an examination to include measurement of the individual\u2019s height, weight, body mass index, blood pressure, a visual acuity screen, and other factors as deemed appropriate, based on the beneficiary\u2019s medical and social history,\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">end-of-life planning, upon agreement of the individual,\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">education, counseling, and referral, as deemed appropriate, based on the results of the review and evaluation services described in the previous 5 elements, and<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">education, counseling, and referral including a brief written plan (e.g., a checklist or alternative) provided to the individual for obtaining the appropriate screening and other preventive services, which are separately covered under Medicare Part B.\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">For more on coding preventive encounters, see <a href=\"https:\/\/www.medicalbillersandcoders.com\/blog\/preventive-medicine-services-coding-guidelines\/\">Preventive Medicine Services Coding Guidelines<\/a>.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You may also find this useful: <a href=\"https:\/\/www.medicalbillersandcoders.com\/blog\/how-does-incorrect-modifier-usage-impact-preventive-care-billing\/\">How Does Incorrect Modifier Usage Impact Preventive Care Billing?<\/a><\/span><\/p>\n<p><span style=\"font-weight: 400;\">For a detailed understanding of Initial Preventive Physical Examination (IPPE), you can refer to CMS\u2019s page on <\/span><a href=\"https:\/\/www.cms.gov\/Outreach-and-Education\/Medicare-Learning-Network-MLN\/MLNProducts\/preventive-services\/medicare-wellness-visits.html\"><span style=\"font-weight: 400;\">\u2018Medicare Wellness Visits\u2019<\/span><\/a><span style=\"font-weight: 400;\">. <\/span><b>Medical Billers and Coders (MBC)<\/b><span style=\"font-weight: 400;\">\u00a0is a <a href=\"https:\/\/www.medicalbillersandcoders.com\/\">leading medical billing company<\/a> providing complete revenue cycle services. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">IPPE claims are often denied when the visit falls outside the 12-month eligibility window or when the patient has already used the benefit. Our <a href=\"https:\/\/www.medicalbillersandcoders.com\/account-analysis-and-denial-management.aspx\"><strong>denial management services<\/strong><\/a> identify these root causes and help recover the revenue owed to your practice.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">We can assist you in billing Medicare for Initial Preventive Physical Examination (IPPE) and for other services. To know more about our <a href=\"https:\/\/www.medicalbillersandcoders.com\/medical-billing-services.aspx\"><strong>medical billing services<\/strong><\/a> and coding support for Medicare and commercial payers, contact us at <a href=\"tel:888-357-3226\"><strong>888-357-3226<\/strong><\/a> \/ <\/span><a href=\"mailto:info@medicalbillersandcoders.com\"><span style=\"font-weight: 400;\">info@medicalbillersandcoders.com<\/span><\/a><\/p>\n<h2>FAQs<\/h2>\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1748444429136\"><strong class=\"schema-faq-question\"><strong>Q: What is the Initial Preventive Physical Examination (IPPE)?<\/strong><\/strong> <p class=\"schema-faq-answer\">A: The IPPE, also known as the &#8216;Welcome to Medicare Preventive Visit,&#8217; is a one-time preventive service offered to Medicare beneficiaries within the first 12 months of their Part B enrollment.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1748444451805\"><strong class=\"schema-faq-question\"><strong>Q: Who can perform the IPPE?<\/strong><\/strong> <p class=\"schema-faq-answer\">A: The IPPE can be performed by a doctor of medicine or osteopathy, or a qualified non-physician practitioner (such as a nurse practitioner, physician assistant, or clinical nurse specialist).<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1748444467338\"><strong class=\"schema-faq-question\"><strong>Q: What is HCPCS code G0402 used for?<\/strong><\/strong> <p class=\"schema-faq-answer\">A: HCPCS code G0402 is used to bill for the face-to-face IPPE visit.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1748444491796\"><strong class=\"schema-faq-question\"><strong>Q: When should HCPCS code G0403 be used?<\/strong><\/strong> <p class=\"schema-faq-answer\">A: HCPCS code G0403 is used to bill for a complete screening electrocardiogram (EKG) during the IPPE, including tracing, interpretation, and report.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1748444508365\"><strong class=\"schema-faq-question\"><strong>Q: What is the difference between HCPCS codes G0404 and G0405?<\/strong><\/strong> <p class=\"schema-faq-answer\">A: G0404 is used for billing only the EKG tracing, while G0405 is used for the interpretation and report of the EKG, without the tracing.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1748444521766\"><strong class=\"schema-faq-question\"><strong>Q: Is a specific diagnosis code required for IPPE billing?<\/strong><\/strong> <p class=\"schema-faq-answer\">A: Medicare does not require a specific diagnosis code for IPPE billing, but you must choose one that is consistent with the patient\u2019s exam.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1748444534650\"><strong class=\"schema-faq-question\"><strong>Q: Can I bill for additional services during the IPPE?<\/strong><\/strong> <p class=\"schema-faq-answer\">A: Yes, if a medically necessary Evaluation and Management (E\/M) service is provided during the IPPE, you can bill it separately using CPT codes 99202\u201399215 with modifier -25.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1748444556774\"><strong class=\"schema-faq-question\"><strong>Q: What does the IPPE include?<\/strong><\/strong> <p class=\"schema-faq-answer\">A: The IPPE includes a review of medical and social history, depression screening, functional ability evaluation, physical exam, end-of-life planning, and counseling or referrals based on findings.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1748444566100\"><strong class=\"schema-faq-question\"><strong>Q: How can MBC assist with IPPE billing?<\/strong><\/strong> <p class=\"schema-faq-answer\">A: Medical Billers and Coders (MBC) can help you accurately bill Medicare for IPPE and other services, ensuring efficient revenue cycle management. Contact us at <strong><a href=\"tel:888-357-3226\">888-357-3226<\/a><\/strong> or <a href=\"mailto:info@medicalbillersandcoders.com\">info@medicalbillersandcoders.com<\/a> for more information.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1791201295842\"><strong class=\"schema-faq-question\"><strong>Q: What is the difference between the IPPE and the Annual Wellness Visit (AWV)?<\/strong><\/strong> <p class=\"schema-faq-answer\">A: The IPPE (G0402) is a one-time visit available only within the first 12 months of Medicare Part B enrollment. The AWV (G0438 for the initial visit, G0439 for subsequent visits) is available once every 12 months after that first year and focuses on a personalized prevention plan.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1791201296953\"><strong class=\"schema-faq-question\"><strong>Q: Does the patient pay anything for the IPPE?<\/strong><\/strong> <p class=\"schema-faq-answer\">A: No. The Part B deductible and coinsurance do not apply to the IPPE (G0402) when the provider accepts assignment. However, the deductible and coinsurance do apply to the screening EKG billed with G0403, G0404, or G0405.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1791201298064\"><strong class=\"schema-faq-question\"><strong>Q: How often can Medicare be billed for the IPPE?<\/strong><\/strong> <p class=\"schema-faq-answer\">A: Only once per beneficiary per lifetime, and only within the first 12 months of Part B coverage. Claims for a second IPPE or for a visit outside this window are denied, so verify eligibility before the visit.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>Initial Preventive Physical Examination (IPPE) The initial preventive physical examination (IPPE) is a preventive visit also known as a \u2018Welcome to Medicare Preventive Visit\u2019. Medicare pays for one IPPE per beneficiary per lifetime for beneficiaries within the first 12 months of the effective date of the beneficiary\u2019s first Part B coverage period. The IPPE may [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":16135,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[3762,120,3766,3763,3102,146,806,3765,187],"class_list":["post-16134","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-billing-services","tag-applicable-hcpcs-codes-for-ippe","tag-cpt-code","tag-hcpcs-code-g0402","tag-ippe","tag-leading-medical-billing-company","tag-medicare-2","tag-medicare-part-b","tag-medicare-preventive-visit","tag-physician"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Billing Medicare for Initial Preventive Physical Examination<\/title>\n<meta name=\"description\" content=\"In this blog, We shared here the meaning of Initial Preventive Physical Examination 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exam.\",\"inLanguage\":\"en-US\"},\"inLanguage\":\"en-US\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/billing-medicare-for-initial-preventive-physical-examination\\\/#faq-question-1748444534650\",\"position\":7,\"url\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/billing-medicare-for-initial-preventive-physical-examination\\\/#faq-question-1748444534650\",\"name\":\"Q: Can I bill for additional services during the IPPE?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"A: Yes, if a medically necessary Evaluation and Management (E\\\/M) service is provided during the IPPE, you can bill it separately using CPT codes 99202\u201399215 with modifier 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Contact us at <strong><a href=\\\"tel:888-357-3226\\\">888-357-3226<\\\/a><\\\/strong> or <a href=\\\"mailto:info@medicalbillersandcoders.com\\\">info@medicalbillersandcoders.com<\\\/a> for more information.\",\"inLanguage\":\"en-US\"},\"inLanguage\":\"en-US\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/billing-medicare-for-initial-preventive-physical-examination\\\/#faq-question-1791201295842\",\"position\":10,\"url\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/billing-medicare-for-initial-preventive-physical-examination\\\/#faq-question-1791201295842\",\"name\":\"Q: What is the difference between the IPPE and the Annual Wellness Visit (AWV)?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"A: The IPPE (G0402) is a one-time visit available only within the first 12 months of Medicare Part B enrollment. 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Dedicated to educating healthcare professionals on compliance, accuracy, and strategies to improve billing performance.","sameAs":["https:\/\/www.medicalbillersandcoders.com\/","https:\/\/www.linkedin.com\/in\/debbie-young-4544a631a\/"],"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/author\/debbie-young\/"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444429136","position":1,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444429136","name":"Q: What is the Initial Preventive Physical Examination (IPPE)?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"A: The IPPE, also known as the 'Welcome to Medicare Preventive Visit,' is a one-time preventive service offered to Medicare beneficiaries within the first 12 months of their Part B enrollment.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444451805","position":2,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444451805","name":"Q: Who can perform the IPPE?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"A: The IPPE can be performed by a doctor of medicine or osteopathy, or a qualified non-physician practitioner (such as a nurse practitioner, physician assistant, or clinical nurse specialist).","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444467338","position":3,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444467338","name":"Q: What is HCPCS code G0402 used for?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"A: HCPCS code G0402 is used to bill for the face-to-face IPPE visit.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444491796","position":4,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444491796","name":"Q: When should HCPCS code G0403 be used?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"A: HCPCS code G0403 is used to bill for a complete screening electrocardiogram (EKG) during the IPPE, including tracing, interpretation, and report.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444508365","position":5,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444508365","name":"Q: What is the difference between HCPCS codes G0404 and G0405?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"A: G0404 is used for billing only the EKG tracing, while G0405 is used for the interpretation and report of the EKG, without the tracing.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444521766","position":6,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444521766","name":"Q: Is a specific diagnosis code required for IPPE billing?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"A: Medicare does not require a specific diagnosis code for IPPE billing, but you must choose one that is consistent with the patient\u2019s exam.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444534650","position":7,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444534650","name":"Q: Can I bill for additional services during the IPPE?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"A: Yes, if a medically necessary Evaluation and Management (E\/M) service is provided during the IPPE, you can bill it separately using CPT codes 99202\u201399215 with modifier -25.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444556774","position":8,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444556774","name":"Q: What does the IPPE include?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"A: The IPPE includes a review of medical and social history, depression screening, functional ability evaluation, physical exam, end-of-life planning, and counseling or referrals based on findings.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444566100","position":9,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1748444566100","name":"Q: How can MBC assist with IPPE billing?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"A: Medical Billers and Coders (MBC) can help you accurately bill Medicare for IPPE and other services, ensuring efficient revenue cycle management. Contact us at <strong><a href=\"tel:888-357-3226\">888-357-3226<\/a><\/strong> or <a href=\"mailto:info@medicalbillersandcoders.com\">info@medicalbillersandcoders.com<\/a> for more information.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1791201295842","position":10,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1791201295842","name":"Q: What is the difference between the IPPE and the Annual Wellness Visit (AWV)?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"A: The IPPE (G0402) is a one-time visit available only within the first 12 months of Medicare Part B enrollment. The AWV (G0438 for the initial visit, G0439 for subsequent visits) is available once every 12 months after that first year and focuses on a personalized prevention plan.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1791201296953","position":11,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1791201296953","name":"Q: Does the patient pay anything for the IPPE?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"A: No. The Part B deductible and coinsurance do not apply to the IPPE (G0402) when the provider accepts assignment. However, the deductible and coinsurance do apply to the screening EKG billed with G0403, G0404, or G0405.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1791201298064","position":12,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-medicare-for-initial-preventive-physical-examination\/#faq-question-1791201298064","name":"Q: How often can Medicare be billed for the IPPE?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"A: Only once per beneficiary per lifetime, and only within the first 12 months of Part B coverage. Claims for a second IPPE or for a visit outside this window are denied, so verify eligibility before the visit.","inLanguage":"en-US"},"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/posts\/16134","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/comments?post=16134"}],"version-history":[{"count":10,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/posts\/16134\/revisions"}],"predecessor-version":[{"id":32459,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/posts\/16134\/revisions\/32459"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/media\/16135"}],"wp:attachment":[{"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/media?parent=16134"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/categories?post=16134"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/tags?post=16134"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}