Story by Connor Danielowski / July 20, 2025
When patients hear “Annual Wellness Visit” and “Annual Physical,” they often assume they’re interchangeable. Both sound like routine check-ups, both are yearly, and both involve a conversation with a provider. But under Medicare guidelines, these two visits serve very different purposes – and mistaking one for the other can lead to billing issues, compliance problems, and confusion for both patients and staff.
At Chronic Care Staffing, we support providers nationwide with services that help bridge this knowledge gap – starting with a clear understanding of what each visit actually includes.
A Medicare Annual Wellness Visit is not a traditional head-to-toe physical exam. Instead, it’s a preventive service covered 100% by Medicare Part B, focused on long-term health planning rather than diagnosis or treatment. AWVs are structured around a Health Risk Assessment (HRA) and are designed to help providers identify potential risk factors, review the patient’s current health status, and build a personalized prevention plan.
What an AWV includes:
Notably, AWVs do not include lab work, diagnostic testing, or physical touch—and any such services delivered at the same time may trigger co-pays or deductibles if billed separately.
In contrast, a traditional Annual Physical is a comprehensive exam that includes both preventive and diagnostic elements. It is often hands-on, covering a physical examination, lab testing, and screening for any new or existing medical issues.
While patients are used to getting physicals from their employer, primary care physician, or as part of general health maintenance, it’s important to note that Medicare does not cover routine physicals under Part B. Any charges associated with a physical exam may fall to the patient unless bundled with a covered service.
What a physical exam includes:
The confusion between AWVs and annual physicals can result in billing errors, patient dissatisfaction, and missed opportunities for preventive care. Educating care teams and front office staff on this distinction is essential to aligning with CMS guidelines and improving both patient engagement and compliance.
| Feature | Annual Wellness Visit (AWV) | Annual Physical |
| Covered by Medicare | ✅ Yes | ❌ No |
| Health Risk Assessment | ✅ Required | ❌ Optional |
| Physical Exam | ❌ Not included | ✅ Yes |
| Lab Work / Blood Tests | ❌ Not included | ✅ Yes |
| Personalized Prevention Plan | ✅ Yes | ❌ No |
| Cognitive Assessment | ✅ Often included | ❌ No |
| Address New Symptoms | ❌ Not included | ✅ Yes |
| Co-pay or Deductible Applies | ❌ No | ✅ Yes (most) |
To qualify for a Medicare AWV:
Eligible providers include physicians, nurse practitioners, physician assistants, and other primary care or in-network clinicians. However, only one provider can bill for an AWV per patient per year so coordination is essential.
Medicare AWVs are more than a compliance box to check – they are a foundational piece of value-based care delivery. AWVs support better health outcomes, earlier identification of chronic risks, and higher CMS quality scores.
AWVs are also proven to increase adherence to screenings and reduce long-term healthcare costs. Studies have shown that patients who receive AWVs are significantly more likely to receive age-appropriate preventive care, such as:
For Accountable Care Organizations (ACOs) and providers engaged in risk-sharing models, AWVs can be a significant driver of shared savings and improved patient satisfaction.
Chronic Care Staffing supports clinics, hospitals, and medical groups by providing turnkey Annual Wellness Visit support, including:
Let us help you boost AWV utilization, improve quality outcomes, and relieve pressure from your in-house care teams. If your organization is looking to scale preventive care services, we’re here to help.
Contact us today to learn how our AWV solutions can support your value-based care goals.
