brevaModifiers on the Annual Wellness Visit claim
Updated October 16, 2026. G0438 and G0439 usually carry no modifier. The modifiers go on the other services billed the same day. Confirm with your Medicare Administrative Contractor before you rely on it for a claim.
The short answer
A wellness visit on its own is billed as G0438 or G0439 with no modifier. When you bill other services on the same claim, the modifier goes on that other service, not on the wellness visit code.
| Service billed with the wellness visit | Modifier | Goes on |
|---|---|---|
| Office visit for a separate problem (99202 to 99215) | 25 | The office visit code |
| Advance care planning (99497, 99498) | 33 | The advance care planning code |
| Physical activity and nutrition assessment (G0136) | 33 | G0136 |
| Annual depression screening (G0444) | None | Billable with G0439 only |
| Visit complexity add-on (G2211) | None | Added to the modifier 25 office visit, never to G0438 or G0439 |
| Cognitive assessment and care plan (99483) | 25 | 99483 |
Modifier 25: a separate problem addressed the same day
When you also manage a significant, separately identifiable problem, bill the office visit with modifier 25 alongside the wellness visit. Document the problem, the history, examination and decision making for it, separately from the wellness visit elements. The patient may owe a deductible and coinsurance for the office visit part; the wellness visit itself has no cost sharing.
Since 2025, G2211 can be added to that modifier 25 office visit when the visit is part of an ongoing relationship for the patient's care. Source: CMS Annual Wellness Visit page.
Modifier 33: preventive services with no cost sharing
Advance care planning is an optional element of the wellness visit. When it is done the same day, by the same provider, bill 99497 (and 99498 for each additional 30 minutes) with modifier 33, and the patient owes nothing for it. The waiver applies once a year with the wellness visit; advance care planning on another day is subject to the deductible and coinsurance. Source: CMS MLN909289, Advance Care Planning.
G0136, the physical activity and nutrition assessment, follows the same rule when billed with the wellness visit.
Codes that take no modifier
- G0444, annual depression screening, up to 15 minutes: billable with G0439. Not payable with G0438 or G0402, and no modifier overrides that edit. Source: NCCI edits.
- G0442 and G0443, alcohol misuse screening and counseling, and other Medicare preventive services can be billed the same day without a modifier when their own frequency limits allow it.
Telehealth
G0438 and G0439 are on the 2026 Medicare Telehealth Services List. Report the place of service that matches where the patient was (10 for home, 02 elsewhere) and follow your MAC's instruction on telehealth modifiers. Source: CMS telehealth list.
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 Annual Wellness Visit page, MLN909289, NCCI procedure to procedure edits, 2026 telehealth list.