HCPCS G0438
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit (CMS descriptor)
Other services Work RVU per service 2.60 (2021 fee schedule)
Trend
Medicare payment on the code
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.
Billers
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.
| observed | calculated | calculated | calculated | calculated | calculated | reported | |
|---|---|---|---|---|---|---|---|
| 2024 | 15,851 | $61,985,969 | -6% | 410,373 | 17 | 60 | 2.60 |
| 2023 | 17,441 | $66,078,763 | -10% | 435,826 | 17 | 61 | 2.60 |
| 2022 | 18,306 | $73,077,051 | -21% | 471,824 | 18 | 64 | 2.60 |
| 2021 | 20,800 | $92,063,682 | -7% | 563,701 | 19 | 68 | 2.60 |
| 2020 | 20,871 | $99,114,878 | first year in data | 591,568 | 19 | 76 | 2.43 |
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.
By state
| observed | calculated | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|---|
| California | 1,523 | $8,427,389 | 48,596 | 20 | 94 | |
| Illinois | 1,292 | $6,086,898 | 35,763 | 19 | 66 | |
| Pennsylvania | 1,341 | $5,928,779 | 35,742 | 19 | 71 | |
| New York | 1,177 | $5,831,683 | 31,232 | 18 | 68 | |
| Florida | 1,158 | $5,491,364 | 34,254 | 20 | 76 | |
| Texas | 1,091 | $4,835,756 | 29,801 | 17 | 71 | |
| Ohio | 1,003 | $4,151,091 | 27,450 | 20 | 62 | |
| Maryland | 629 | $3,315,880 | 19,185 | 20 | 60 | |
| North Carolina | 709 | $3,302,734 | 20,795 | 19 | 76 | |
| New Jersey | 596 | $2,947,059 | 16,619 | 19 | 68 | |
| Indiana | 682 | $2,763,097 | 17,998 | 18 | 66 | |
| South Carolina | 540 | $2,637,695 | 16,717 | 20 | 81 | |
| Virginia | 607 | $2,514,404 | 15,584 | 19 | 60 | |
| Georgia | 518 | $2,250,101 | 14,268 | 19 | 62 | |
| Massachusetts | 557 | $2,186,912 | 13,370 | 17 | 58 |
Not listed: 3 states with fewer than 11 billers (small cells).
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2021.
Top metro areas
| observed | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|
| New York-Newark-Jersey City, NY-NJ | 1,119 | $6,197,461 | 32,306 | 19 | |
| Chicago-Naperville-Elgin, IL-IN | 1,124 | $5,041,719 | 29,292 | 19 | |
| Philadelphia-Camden-Wilmington, PA-NJ-DE-MD | 655 | $2,937,910 | 17,302 | 20 | |
| Los Angeles-Long Beach-Anaheim, CA | 462 | $2,569,616 | 14,453 | 20 | |
| Boston-Cambridge-Newton, MA-NH | 379 | $1,474,274 | 8,405 | 18 | |
| Baltimore-Columbia-Towson, MD | 332 | $1,433,460 | 8,218 | 19 | |
| Washington-Arlington-Alexandria, DC-VA-MD-WV | 309 | $1,359,487 | 7,679 | 18 | |
| Atlanta-Sandy Springs-Roswell, GA | 268 | $1,342,362 | 8,317 | 20 | |
| St. Louis, MO-IL | 248 | $1,245,512 | 7,614 | 19 | |
| Minneapolis-St. Paul-Bloomington, MN-WI | 393 | $1,210,138 | 7,402 | 16 | |
| Houston-Pasadena-The Woodlands, TX | 251 | $1,181,798 | 7,010 | 18 | |
| Cincinnati, OH-KY-IN | 294 | $1,148,147 | 7,474 | 18 | |
| Allentown-Bethlehem-Easton, PA-NJ | 174 | $1,115,426 | 6,670 | 32 | |
| Miami-Fort Lauderdale-West Palm Beach, FL | 261 | $1,069,052 | 6,266 | 18 | |
| Detroit-Warren-Dearborn, MI | 300 | $1,048,690 | 6,392 | 17 |
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 98 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2021.
Specialties billing G0438 nationally
Family Practice accounts for 42% of payment for G0438 nationally in 2021, across 17 specialties on claims.
| observed | calculated | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|---|
| Family Practice | 9,211 | 44% | $38,771,916 | 42% | 235,227 | 26 |
| Internal Medicine | 7,444 | 36% | $36,083,867 | 39% | 211,791 | 28 |
| Nurse Practitioner | 2,666 | 13% | $10,106,158 | 11% | 72,103 | 27 |
| Physician Assistant | 741 | 3.6% | $2,427,384 | 2.6% | 17,334 | 23 |
| General Practice | 194 | 0.93% | $1,013,575 | 1.1% | 5,915 | 30 |
| Emergency Medicine | 55 | 0.26% | $930,446 | 1.0% | 5,732 | 104 |
| Geriatric Medicine | 81 | 0.39% | $499,428 | 0.54% | 2,976 | 37 |
| Hospitalist | 64 | 0.31% | $337,582 | 0.37% | 1,993 | 31 |
| Cardiology | 49 | 0.24% | $279,529 | 0.30% | 1,526 | 31 |
| Obstetrics & Gynecology | 59 | 0.28% | $252,616 | 0.27% | 1,390 | 24 |
| Pediatric Medicine | 52 | 0.25% | $221,779 | 0.24% | 1,316 | 25 |
| Nephrology | 29 | 0.14% | $189,056 | 0.21% | 1,041 | 36 |
| Osteopathic Manipulative Medicine | 13 | 0.06% | $81,244 | 0.09% | 468 | 36 |
| Endocrinology | 16 | 0.08% | $69,290 | 0.08% | 421 | 26 |
| Pulmonary Disease | 16 | 0.08% | $60,317 | 0.07% | 338 | 21 |
Not listed: 25 specialties with fewer than 11 billers (small cells).
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2021.
Top billers of G0438 nationally
Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.
Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations