Medicare Annual Wellness Visit: What's Covered & How It Differs From a Physical

The Annual Wellness Visit (AWV) is one of Medicare's most helpful, but underutilized preventive services. The AWV differs in many ways from the traditional annual physical exam, and is covered 100% by Part B without any copay, deductibles, or coinsurance when the provider accepts assignment. Annual physicals (the thorough examination and full range of tests and laboratory work from head to toe) are not covered by Medicare. Rather, the AWV is an appointment to develop or revise a personalized plan to prevent further problems; to do a dementia/Alzheimer's cognitive screening; to screen for depression and substance use; to assess fall risk; and to identify areas of recommended preventive services. Under a new Medicare preventative care framework, effective Jan. 1, 2026, Medicare added a new standardized physical activity and nutrition assessment, which will be billable every six months with the AWV. Additionally, beginning in 2026, CMS added new virtual direct supervision rules, meaning that more flexibility will be available for integrating virtual services into preventive care.

The Medicare Annual Wellness Visit is a guide that will explain what it is, what's covered, what it isn't covered and what it will update in 2026. Data is from Medicare.gov, CMS, and the U.S. Preventive Services Task Force.

What the Annual Wellness Visit covers

The Annual Wellness Visit is a comprehensive preventive care visit with specific covered elements. Your provider requires that you fill out a questionnaire called a Health Risk Assessment (HRA) before or at the time of your visit. The HRA includes information about your medical and health history, medications, family health history, lifestyle habits, mental health, and functional status.

The visit includes standard examinations such as height, weight, body mass index (BMI) and blood pressure. Your provider makes a cognitive evaluation for any signs of dementia or Alzheimer's disease with validated screening tools beyond just a physical exam. Depression screening can detect mental health issues that can be treated.

Your provider checks your drugs and looks for possible interactions or problem drugs. A safety assessment would consider fall risk, home safety hazards and other preventable risks for injury. Your provider may also complete a Social Determinants of Health Risk Assessment (SDOH) to learn about the social determinants of health (housing, transportation, food security, social isolation) that impact your health.

The visit results in a personalized prevention plan and a written checklist of preventive services and screenings recommended for you. This usually encompasses cancer screening, immunizations, blood pressure and cholesterol control and lifestyle advice.

The Medicare physical activity and nutrition assessment, which is consistent across all plans, will be available to bill as a part of the AWV every six months starting January 1, 2026. This new module measures levels of activity, eating habits and offers counseling about healthy lifestyle changes. Individuals with worrisome results may be referred for nutrition counseling or exercise programs.

To see the Medicare coverage in detail, check out our Medicare guide. 

How the AWV differs from an annual physical

The most frequent misunderstanding about the Medicare AWV is that it is a thorough physical examination. They're fundamentally different services with different purposes, components, and coverage.

Traditional annual physical exam is a thorough exam that evaluates all systems of the body from head to toe, heart and lung exam with stethoscope, abdominal exam, neurological exam, vision and hearing exam, lab tests, urinalysis, reflexes, and diagnostic testing (as needed) are performed and hands-on physical exam of body systems.

These are NOT included in the Medicare AWV. A planning and screening examination in the absence of hands-on physical examination other than vital signs.

Annual physicals are not covered by Medicare. A traditional physical exam will cost you typically out of pocket or through other insurance coverage. Original Medicare does not include routine physical exams as a supplemental benefit. Original Medicare may have supplemental benefits.Original Medicare may include extra benefits such as routine physical exams.

If scheduled separately, it is possible to have both an AWV and a physical exam on the same day; the physical exam part is not covered by Medicare. The cost of the physical exam would be paid out of pocket or by other insurance. For chronic conditions that are discussed during the AWV, some practices charge extra for the additional time as "evaluation and management" services. You may have copayments on these extra services and they also count toward your deductible. 

The Welcome to Medicare visit (IPPE)

The Initial Preventive Physical Examination (IPPE), commonly called the "Welcome to Medicare" visit, is a one-time benefit available within the first 12 months of your Medicare Part B enrollment.

The IPPE serves as your introduction to Medicare's preventive care framework. It includes medical and social history review, BMI calculation, simple vision test, mental health and cognitive function screening (depression, substance use, dementia), substance use disorder risk evaluation, optional Social Determinants of Health Risk Assessment, fall risk evaluation, and referrals for follow-up care as needed.

Important to note: the IPPE is NOT a physical exam. It's a preventive planning visit similar to the AWV but conducted within your first year of Medicare coverage. Like the AWV, you pay nothing for the IPPE if your provider accepts assignment.

You can't have your first AWV within 12 months of your Part B enrollment, regardless of whether you used the IPPE benefit. However, you don't need to have had the IPPE to qualify for AWVs. The IPPE is optional but recommended.

After your IPPE (or once you've had Part B for more than 12 months), you can have your first AWV. This is called the Initial Annual Wellness Visit (HCPCS code G0438). Each subsequent yearly visit is called a Subsequent Annual Wellness Visit (G0439).

For Medicare enrollment information, see our enrollment periods guide.

2026 updates to the Annual Wellness Visit

Several 2026 changes enhance the Annual Wellness Visit. The new standardized physical activity and nutrition assessment, effective January 1, 2026, can be billed every six months as part of the AWV. This expands the preventive care framework beyond the once-yearly AWV.

The assessment evaluates physical activity levels using validated tools and provides personalized counseling on healthy levels of physical activity. Nutrition assessment includes dietary habits, food security concerns, and counseling on healthy eating patterns. Patients with concerning findings may receive referrals to registered dietitians, exercise programs, or specialty care.

CMS also expanded virtual direct supervision rules starting 2026. This allows more flexibility for integrating telehealth into preventive care workflows. Patients may now receive certain components of AWV services remotely with appropriate supervision.

The expanded preventive services can lead to more comprehensive care planning, particularly for patients with multiple chronic conditions, social determinants of health concerns, or who would benefit from frequent lifestyle counseling.

How to schedule and prepare for your AWV

Scheduling your AWV is straightforward. Contact your primary care provider's office and specifically request an "Annual Wellness Visit" or "Medicare Annual Wellness Visit." Use the exact terminology to avoid confusion with other appointment types. If asked, mention you're scheduling the Medicare AWV, not a physical exam.

Before your visit, complete several preparation steps. Fill out the Health Risk Assessment questionnaire if your provider sends it in advance. Gather your medical history, including any new diagnoses, surgeries, or major events since your last visit. List all current medications including dosages, over-the-counter medications, and supplements. Prepare information about your healthcare providers (specialists, dentist, optometrist). Think about your goals and concerns for your health planning.

During your visit, focus on prevention planning rather than active medical issues. If you have new symptoms or chronic conditions needing evaluation, schedule a separate appointment for those issues. Mixing the AWV with active medical care can lead to billing complications where part of the visit isn't covered by Medicare's preventive benefit.

Ask your provider for a written copy of your personalized prevention plan. The plan should include specific recommended screenings, vaccinations, and lifestyle counseling with timelines. Refer to it throughout the year to ensure you're following through on recommended care.

What's NOT covered during the AWV

There are a number of items not covered by the AWV preventive benefit. Treatment of chronic diseases or symptoms is not considered preventive treatment. Some services may be provided separately during the AWV, and be subject to copayment if the provider treats specific issues.

Lab work isn't part of the AWV. Under Medicare coverage, the cost of annual laboratory tests, blood tests and other diagnostic lab services are paid in addition to the cost of the other covered services. You pay 20% coinsurance after the Part B deductible for lab work.

Hands-on physical examination of body systems isn't included. The AWV is not an examination-based assessment, but a planning based one.

Fixed vision and hearing assessments (apart from the vision check at the IPPE) are not included. Medicare does not pay for routine eye exams (eye doctors who accept Medicaid  will have options for them).

The AWV does not include diagnostic services such as ECG, x-rays and other tests. These may be ordered individually as Part B services as needed.