Physical examination versus annual wellness visit: The differences are explained

Can you tell the difference between an annual physical examination and an annual wellness visit (AWV)?

Question: Can you tell me the difference between an annual physical and an annual wellness visit (AWV)?

Answer: Although both types of exams take into account prevention, there are many differences between them.

The annual medical examination is a broader exam than the annual wellness visit to Medicare. A typical annual physical examination is a “practical” visit, including a physical examination and any blood or laboratory tests that may be part of the test or necessary for the patient’s chronic stable problems.

Alternatively, AWV is a hands-free risk assessment. The purpose of AWV is to identify gaps in care, to improve the quality of care provided by the provider, and to help create a picture of the patient’s current health to provide a basis for future care.

What is included in the physical exam?

The annual physical examination is an assessment of the health of your body. The main goal is to look for health problems.

During the exam, your doctor uses his senses – mainly sight, touch and hearing – to assess how your body is performing. Based on what you have learned, your doctor may ask you to do tests to detect or rule out possible health problems.

The list below shows some of the things a doctor can do during a physical examination.

Visually inspect the patient’s body as a whole for signs of existing health problems:

  • Examine the patient’s eyes, ears, nose and throat for potential problems
  • Listen to the patient’s heart and lungs to detect incorrect sounds
  • Test motor function and reflexes
  • Perform pelvic and rectal examinations
  • Measure height, weight and blood pressure

Send or order urine and blood samples for laboratory testing, screening and ongoing chronic conditions

As a rule, Medicare does not cover an annual individual. The exam and all the tests your doctor orders are separate services and you may have costs associated with each, depending on your Medicare plan.

What is included in a Medicare wellness visit?

Medicare AWV, also called the wellness exam, is an assessment of a patient’s overall health and well-being. The main goal of prevention is to develop or update a personalized patient prevention plan. Medicare covers AWV once every 12 months (it must have been 11 full months since your last visit) and patients are eligible for this benefit after having had Part B for at least 12 months.

During the exam, a doctor or APP (usually a primary care provider) combines the information from the visit with the patient’s medical record to assess the risk of commonly preventable health problems such as heart disease, cancer and type 2 diabetes. your doctor creates your personal prevention plan with a checklist of checkups that you should have.

The list below shows what needs to be done during the wellness exam.

Review your health risk assessment (questions you answer about your health)

  • Confirm the patient’s medical and family history
  • Write down current medications (including prescriptions and over-the-counter medications) and suppliers
  • Measure and document the patient’s height, weight and blood pressure
  • Look for signs of memory loss, dementia, weakness, depression, stress, pain and fatigue
  • Examine behavioral risks, including tobacco use, physical activity, nutrition, oral health, alcohol consumption, sexual health, motor vehicle (ie, seat belt use), and home safety
  • Evaluate daily activities (ADL)
  • Document the risk factors for the patient’s health and treatment options, including referral to education and counseling programs
  • Provide personalized health advice
  • Develop a screening schedule (as a checklist) for the prevention services recommended for you
  • Review Potential Risk Factors for Opioid Disorder (OUD)
  • Potential Substance Abuse Screen (SUD)
  • Advance care planning (eg living will, power of attorney) if the patient chooses

Medicare Part B covers an annual wellness visit and many preventative check-ups at no extra charge or deduction. However, you may have to pay part of the cost for certain recommended tests or services.

Renee Dowling is a compliance auditor for Sansum Clinic, LLC, Santa Barbara, California.

Leave a Comment