brevaG0402 vs G0438: the Welcome to Medicare visit and the first wellness visit
Updated October 16, 2026. They are different benefits with different windows. The IPPE belongs to the first year of Part B; the first Annual Wellness Visit comes after it. Confirm with your Medicare Administrative Contractor before you rely on it for a claim.
The short answer
| G0402 (IPPE) | G0438 (initial AWV) | |
|---|---|---|
| Name | Initial Preventive Physical Examination, the Welcome to Medicare visit | Annual Wellness Visit (Initial) |
| When | Within the first 12 months of Part B | After the first 12 months of Part B, and 12 months after any IPPE |
| How often | Once per lifetime | Once per lifetime |
| Patient cost | None | None |
| Telehealth in 2026 | Not on the list | On the list |
| 2026 national amount | $174.69 | $174.35 |
What the IPPE includes
Under 42 CFR 410.16 and the CMS IPPE page, the IPPE is a review and counseling visit, not a head-to-toe physical:
- Review of medical and social history, including current medications and supplements
- Review of risk factors for depression and other mood disorders
- Review of functional ability and safety
- Height, weight, body mass index, blood pressure and visual acuity
- End-of-life planning, at the patient's discretion
- Review of current opioid prescriptions and screening for substance use disorders
- Education, counseling and referrals based on the review, and a written plan for the screening and preventive services the patient is eligible for
- A once-per-lifetime screening EKG, if the clinician refers for it: G0403 (complete), G0404 (tracing only) or G0405 (interpretation and report only)
What changes at the first wellness visit
The Annual Wellness Visit adds the health risk assessment, the list of current providers and suppliers, detection of cognitive impairment, and the written screening schedule for the next 5 to 10 years with a risk factor and intervention list. It drops visual acuity. See the personalized prevention plan checklist for the full list.
Timing between them
A patient who has an IPPE must wait 12 months before G0438. A patient who never had an IPPE can have G0438 as soon as the first 12 months of Part B have passed. The IPPE is not a prerequisite. See eligibility and timing.
Billing with other services
Modifier 25 applies to a separate office visit on the same day for both codes. G0444 depression screening is not payable with G0402 or G0438; it can be billed with G0439. Advance care planning with modifier 33 is free of cost sharing with either visit when done the same day. See modifiers on the wellness visit claim.
Read next
G0438 vs G0439. Payment amounts, denial codes and the 2026 telehealth rules are on the Annual Wellness Visit coding reference.
Printable note templates: initial Annual Wellness Visit and subsequent Annual Wellness Visit. For the patient: a printable health risk assessment form.
Record the wellness visit in Breva and review the note and its suggested codes before they reach the chart. The Breva scribe.
Sources
CMS IPPE page, 42 CFR 410.16, CMS Annual Wellness Visit page, Claims Processing Manual chapter 18, 2026 telehealth list.