Physical exam vs. annual wellness visit: The differences explained

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

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

Answer: While both types of exams have prevention in mind, there are many differences between them.

An annual physical exam is a more comprehensive exam than an Annual Medicare Wellness Visit. A typical annual physical is a “hands-on” type of visit, including a physical exam and any blood or lab tests that may be part of the exam or necessary for the patient’s ongoing chronic problems.

Otherwise, the AWV is a “submitted” risk assessment. The purpose of the AWV is to identify gaps in care, improve the quality of care a provider provides, and help create a picture of a patient’s current health status. a basis for future care.

What is included in a physical exam?

An annual physical exam is an assessment of your body’s health. The main purpose is to search for health problems.

During the exam, your doctor uses his or her senses—primarily sight, touch, and hearing—to assess how your body is working. Based on what is learned, your doctor may ask you to have tests to detect or rule out potential health problems.

The following list shows some of the things a doctor may do during a physical exam.

Visually check the patient’s body in general for signs of existing health problems:

  • Perform an examination of the patient’s eyes, ears, nose, and throat for possible problems
  • Listen to the patient’s heart and lungs for irregular sounds
  • Test motor function and reflexes
  • Perform pelvic and rectal examinations
  • Measure height, weight and blood pressure

Submit or order urine and blood samples for laboratory tests, for screening purposes and for ongoing chronic conditions

As a rule, Medicare does not cover an annual physical. The exam and any 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?

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

During the screening, a doctor or APP (usually a primary care provider) combines information from the visit with the patient’s medical record to estimate your risk for common preventable health problems such as heart disease, cancer, and type 2 diabetes. Based on what is learned, your doctor creates your personal prevention plan with a checklist of examinations you should have.

The list below shows what should be done during a health exam.

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

  • Confirm the patient’s medical and family history
  • Record current medications (including prescriptions and over-the-counter medications) and providers
  • Measure and document the patient’s height, weight, and blood pressure
  • Look for signs of memory loss, dementia, weakness, depression, stress, pain and fatigue
  • Review behavioral risks, including tobacco use, physical activity, nutrition, oral health, alcohol consumption, sexual health, motor vehicles (ie, seat belt use), and home safety
  • Assess activities of daily living (ADL)
  • Document the patient’s health risk factors and treatment options, including referrals to education and counseling programs
  • Provide personalized health advice
  • Develop a screening schedule (like a checklist) for the preventive services recommended for you
  • Review potential risk factors for Opioid Use Disorder (OUD)
  • Screen for Potential Substance Use Disorders (SUDs)
  • Advance care planning (eg, living will, health care power of attorney), if desired by the patient

Medicare Part B covers an Annual Wellness Visit and many free or deductible preventive exams. However, you may have to pay part of the cost for some recommended tests or services.

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

Leave a Comment

Your email address will not be published.