G0438 HCPCS - ANNUAL WELLNESS VISIT; INCLUDES A PERSONALIZED PREVENTION PLAN OF SERVICE (PPS), INITIAL VISIT

Code Information

HCPCS Code: G0438

Sequence Number: 0010

Short Description: Ppps, initial visit

Long Description: Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit

Code Added Date: 1/1/2011

Action Code: N - No maintenance for this code

Action Effective Date: 1/1/2011

Classification: Temporary Procedures & Professional Services

Coding System: HCPCS

Code Type

Berenson-Eggers Type Of Service Code: M5D - Specialist - other
Type Of Service Code:
  • 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96

Billing Information

Pricing Indicator Code:
  • 13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
    N/A
    Medicare Carriers Manual Reference Section Number:
      N/A
      Coverage Code: C - Carrier judgment

      HCPCS Record

      Field Name Field Value
      Healthcare Common Procedure Coding System Code G0438
      HCPCS Sequence Number 0010
      HCPCS Record Identification Code 3 - First line of procedure record also contains detail information in positions 92-275
      HCPCS Long Description Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
      HCPCS Short Description Ppps, initial visit
      HCPCS Pricing Indicator Code 1 13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)
      HCPCS Multiple Pricing Indicator Code A - Not applicable as HCPCS priced under one methodology
      HCPCS Coverage Code C - Carrier judgment
      HCPCS Berenson-Eggers Type Of Service Code M5D - Specialist - other
      HCPCS Type Of Service Code 1 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96
      HCPCS Anesthesia Base Unit Quantity 0
      HCPCS Code Added Date 1/1/2011
      HCPCS Action Effective Date 1/1/2011
      HCPCS Action Code N - No maintenance for this code

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      This page was last updated on: 1/1/2018