{"id":1709,"date":"2024-07-12T03:27:58","date_gmt":"2024-07-12T03:27:58","guid":{"rendered":"https:\/\/zenmedinc.com\/blog\/?p=1709"},"modified":"2024-12-07T13:08:49","modified_gmt":"2024-12-07T13:08:49","slug":"annual-wellness-visit","status":"publish","type":"post","link":"https:\/\/zenmedinc.com\/blog\/annual-wellness-visit\/","title":{"rendered":"BREAKING DOWN THE SDOH AND HOW IT APPLIES TO THE ANNUAL WELLNESS VISIT IN 2024"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"1709\" class=\"elementor elementor-1709\">\n\t\t\t\t<div class=\"elementor-element elementor-element-604ace6 e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no e-con e-parent\" data-id=\"604ace6\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6c2ab12 elementor-widget elementor-widget-text-editor\" data-id=\"6c2ab12\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"color: #000000;\"><span style=\"font-size: small;\">Well, here we are into the third quarter of 2024 and by now, if you\u2019re a provider in private practice, you (and any other providers that may be working for you\/with you), should have performed an Annual Wellness Visit (AWV), on most, if not all your active patients and hopefully, have included a Social Determinants of Health screening (SDOH). CMS implemented changes to the Annual Wellness Visit (AWV), and the Health Risk Assessment (HRA) as of January 1<\/span><sup><span style=\"font-size: small;\">st<\/span><\/sup><span style=\"font-size: small;\">, 2024, which now includes an optional SDOH Risk Assessment for office-based providers and a mandatory directive to provide the SDOH for inpatient providers. <\/span><\/span><\/p>\n<p><span style=\"color: #000000;\"><span style=\"font-size: small;\">This new optional 13<\/span><sup><span style=\"font-size: small;\">th<\/span><\/sup><span style=\"font-size: small;\"> component, of what was always a twelve (12), component AWV, applies to both office-based and inpatient facilities, but as I stated above, is \u201coptional\u201d for office-based and \u201crequires\u201d it for Hospitals and other inpatient type facilities as of January 1<\/span><sup><span style=\"font-size: small;\">st<\/span><\/sup><span style=\"font-size: small;\">, 2024. The good news for all providers and facilities is CMS will allow for additional payment on top of the reimbursement for the standard AWV.<\/span><\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\">If you want to view the updated HRA with SDOH minimum elements, you can click on the link for \u201cA Framework for Patient-Centered Health Risk Assessments\u201d<\/span><\/p>\n<p><span style=\"font-size: small;\">(<\/span><span style=\"color: #467886;\"><u><a href=\"https:\/\/www.cdc.gov\/policy\/paeo\/hra\/frameworkforhra.pdf\"><span style=\"font-size: small;\"><span style=\"color: #0000ff;\">https:\/\/www.cdc.gov\/policy\/paeo\/hra\/frameworkforhra.pdf<\/span><\/span><\/a><\/u><\/span><span style=\"font-size: small;\">) <\/span><span style=\"font-size: small; color: #000000;\">Providers will be able to see more details, including a sample HRA with the SDOH data that CMS is requesting when provided. <\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\">Of note from the Federal Register, the new SDOH assessment must adhere with a set of uniform, proven practices, and ensure that all modes of communication, align and sync with the patient\u2019s demographic for all areas of education, development, healthcare comprehension and must be socially and verbally appropriate. The rationale for the SDOH is to boost patient-centered care and ensure efficacy for the administration providing an AWV. The good news for patients &#8211; they will not be subject to a deductible or Part B coinsurance by partaking in an annual AWV. <\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\">For more information: (<span style=\"color: #0000ff;\">https:\/\/www.federalregister.gov\/documents\/2023\/11\/16\/2023-24184\/medicare-and-medicaid-programs-cy-2024-payment-policies-under-the-physician-fee-schedule-and-other#h-512<span style=\"color: #000000;\">)<\/span><\/span><\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\"><b>Coding for the SDOH:<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\"><span style=\"font-size: small;\">To better track and assist providers and facilities as they provide the new SDOH component, CMS has created a new HCPCS code, <\/span><span style=\"font-size: small;\"><i><b>G0136 &#8211; administration of a standardized, evidence-based SDOH assessment, 5\u201315 minutes. <\/b><\/i><\/span><span style=\"font-size: small;\">This new HCPCS code for the SDOH, is not to be performed or reported, more than 1-2 times a year. <\/span><\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\"><b>CMS has stated that the SDOH may be provided with the following: <\/b><\/span><\/p>\n<ul>\n<li><span style=\"font-size: small; color: #000000;\"><i>An evaluation and management (E&amp;M) encounter, which can include office-based, inpatient, hospital discharge or transitional care management services. <\/i><\/span><\/li>\n<li><span style=\"font-size: small; color: #000000;\"><i>Behavioral health encounters, which can include psychiatric diagnostic evaluation and\/or a health behavior assessment and intervention. <\/i><\/span><\/li>\n<\/ul>\n<p><span style=\"font-size: small; color: #000000;\"><b>Breakdown:<\/b><\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\">When a provider furnishes an AWV, any SDOH risk assessments that are provided as part of an E&amp;M encounter or Behavioral health encounter, isn\u2019t considered a screening, although it may be medically necessary as part the data elements of a social history (PFSH). It is only when a provider feels there is adequate reason to support SDOH needs are not being met, which hinder the providers ability to diagnose and treat a specific illness and\/or chronic condition that negatively impacts the plan of care (POC). In this instance, the patient will be responsible for their cost share, just as they would with any regular encounter\/visit. In this scenario, the SDOH assessment wouldn\u2019t normally be provided ahead of the encounter. <\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\"><b>Example: <\/b><\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\">John Smith, a patient of Dr Jones, and a Type 2 Diabetic, has not had an office visit in six months, requests an appointment for 10-days from today at 1pm to refill refrigerated medication that went bad from a power outage when his electricity was shut off for non-payment. Mr. Smith must use public transportation which has limited availability in his area. If Mr. Smith has not received an SDOH assessment in the past 6 months, then the office of Dr Jones can have Mr. Smith complete an SDOH risk assessment 7\u201310 days in advance of his appointment which will be part of his intake information and it ensures that Dr Jones will have adequate information to treat and provide an appropriate plan of care (POC). <\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\">Providers can provide an SDOH risk assessment as an elective component of an AWV. In this scenario, CMS looks at as a preventive service, which removes the patient cost sharing responsibility, when done once a year and billed in conjunction with the AWV. To be clear, the SDOH risk assessment applies to a thorough look at the patients SDOH needs, along with any detected community risk factors affecting diagnosis and plan of care (POC) for any and all current medical conditions. Providers should use a recognized SDOH risk assessment tool which will allow them to identify the following as it pertains to their patients: <\/span><\/p>\n<ul>\n<li><span style=\"font-size: small; color: #000000;\"><i>Lodging\/shelter\/home uncertainty \/anxiety<\/i><\/span><\/li>\n<li><span style=\"font-size: small; color: #000000;\"><i>Nutrition\/dietary\/food uncertainty \/anxiety<\/i><\/span><\/li>\n<li><span style=\"font-size: small; color: #000000;\"><i>Public or personal modes of transportation accessibility <\/i><\/span><\/li>\n<li><span style=\"font-size: small; color: #000000;\"><i>Utility obstacles\/accessibility<\/i><\/span><\/li>\n<\/ul>\n<p><span style=\"font-size: small; color: #000000;\"><b>Diagnosis Code Selection:<\/b><\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\">Providers should report diagnosis codes that are congruent and relative to a patient\u2019s current health status on exam. CMS does not require a specific diagnoses code(s), in order to submit either an optional or mandatory SDOH Risk Assessment claim as a component of an AWV. <\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\"><b>Billing<\/b><\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\">The implementation date for SDOH Risk Assessment claims is July 1, 2024. We waive both the Part B SDOH Risk Assessment coinsurance and deductible when the following applies:<\/span><\/p>\n<ul>\n<li><span style=\"font-size: small; color: #000000;\">Provided on the same day as the covered AWV<\/span><\/li>\n<li><span style=\"font-size: small; color: #000000;\">Provided by the same provider as the covered AWV<\/span><\/li>\n<li><span style=\"font-size: small; color: #000000;\">Billed with modifier 33 (Preventive Service)<\/span><\/li>\n<li><span style=\"font-size: small; color: #000000;\">Billed on the same claim as the AWV<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><span style=\"font-size: small;\"><b>TIP: <\/b><\/span><span style=\"font-size: small;\">CMS has added G0136 to telehealth services permanently<\/span><\/span><\/p>\n<p><span style=\"color: #000000;\"><span style=\"font-size: small;\"><b>TIP:<\/b><\/span><span style=\"font-size: small;\"> When a provider feels it is appropriate to do an SDOH risk assessment as an optional or mandatory additional element of an AWV, it should be reported with the same DOS on the same claim as G0438 (Annual wellness visit; includes a personalized prevention plan of service (PPPS), initial visit), or G0439 (Annual wellness visit, includes a personalized prevention plan of service (PPPS), subsequent visit). Providers can also document and provide various components of the AWV over a course of several days and then would report the HCPCS codes for everything on the actual date of completion for all components of the AWV, which includes the SDOH. <\/span><\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\"><b>CONCLUSION:<\/b><\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\">Providers in office based practices should seriously consider the benefits of providing the SDOH for both their patients and the business side of the practice. Adding the SDOH is important when assessing patient histories, medical decision making, diagnosis, treatment, and plan of care. CMS and Healthy People 2030,<br>\n<\/span><\/p>\n<p><span style=\"color: #0000ff;\"><span style=\"font-size: small;\">(<\/span><u><a style=\"color: #0000ff;\" href=\"https:\/\/health.gov\/healthypeople\"><span style=\"font-size: small;\">https:\/\/health.gov\/healthypeople<\/span><\/a><\/u><\/span><span style=\"font-size: small;\"><span style=\"color: #0000ff;\">),<\/span> <span style=\"color: #000000;\">has estimated that roughly close to fifty percent of an individual&#8217;s healthcare comes from a direct correlation with the SDOH. From Healthy People 2030, they stated the following \u201cThe conditions in the environment where people are born, live, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.\u201d<\/span><\/span><\/p>\n<p><span style=\"font-size: small; color: #000000;\"><b>AWV Resources:<\/b><\/span><\/p>\n<ul>\n<li><span style=\"color: #0000ff;\"><u><a style=\"color: #0000ff;\" href=\"https:\/\/www.ecfr.gov\/current\/title-42\/chapter-IV\/subchapter-B\/part-410\/subpart-B\/section-410.15\"><span style=\"font-size: small;\">https:\/\/www.ecfr.gov\/current\/title-42\/chapter-IV\/subchapter-B\/part-410\/subpart-B\/section-410.15<\/span><\/a><\/u><\/span><\/li>\n<li><span style=\"color: #0000ff;\"><u><a style=\"color: #0000ff;\" href=\"https:\/\/www.cms.gov\/Regulations-and-Guidance\/Guidance\/Manuals\/Downloads\/clm104c12.pdf#page=30\"><span style=\"font-size: small;\">https:\/\/www.cms.gov\/Regulations-and-Guidance\/Guidance\/Manuals\/Downloads\/clm104c12.pdf#page=30<\/span><\/a><\/u><\/span><\/li>\n<li><span style=\"color: #0000ff;\"><u><a style=\"color: #0000ff;\" href=\"https:\/\/www.cms.gov\/regulations-and-guidance\/guidance\/manuals\/downloads\/clm104c18pdf.pdf#page=161\"><span style=\"font-size: small;\">https:\/\/www.cms.gov\/regulations-and-guidance\/guidance\/manuals\/downloads\/clm104c18pdf.pdf#page=161<\/span><\/a><\/u><\/span><\/li>\n<li><span style=\"color: #0000ff;\"><u><a style=\"color: #0000ff;\" href=\"https:\/\/www.uspreventiveservicestaskforce.org\/uspstf\/recommendation-topics\/uspstf-a-and-b-recommendations\"><span style=\"font-size: small;\">https:\/\/www.uspreventiveservicestaskforce.org\/uspstf\/recommendation-topics\/uspstf-a-and-b-recommendations<\/span><\/a><\/u><\/span><\/li>\n<li><span style=\"color: #0000ff;\"><u><a style=\"color: #0000ff;\" href=\"https:\/\/www.cms.gov\/Outreach-and-Education\/Medicare-Learning-Network-MLN\/MLNProducts\/preventive-services\/medicare-wellness-visits.html\"><span style=\"font-size: small;\">https:\/\/www.cms.gov\/Outreach-and-Education\/Medicare-Learning-Network-MLN\/MLNProducts\/preventive-services\/medicare-wellness-visits.html<\/span><\/a><\/u><\/span><\/li>\n<li><span style=\"color: #0000ff;\"><u><a style=\"color: #0000ff;\" href=\"https:\/\/www.cdc.gov\/policy\/paeo\/hra\/frameworkforhra.pdf\"><span style=\"font-size: small;\">https:\/\/www.cdc.gov\/policy\/paeo\/hra\/frameworkforhra.pdf<\/span><\/a><\/u><\/span><\/li>\n<li><span style=\"text-decoration: underline;\"><span style=\"color: #0000ff;\"><a style=\"color: #0000ff; text-decoration: underline;\" href=\"https:\/\/zenmedinc.com\/blog\/wp-content\/uploads\/2024\/08\/07112024-JH-JL-JN-Review-of-Preventive-Services.pdf\"><span style=\"font-size: small;\">Comprehensive Review of Medicare Preventive Screening Services<\/span><\/a><\/span><\/span><\/li>\n<li><a href=\"https:\/\/zenmedinc.com\/blog\/wp-content\/uploads\/2024\/08\/MM13486.pdf\"><span style=\"color: #0000ff;\"><span style=\"text-decoration: underline;\"><span style=\"font-size: small;\">Annual Wellness Visit: Social Determinants of Health Risk Assessment<\/span><\/span><\/span><\/a><\/li>\n<\/ul>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter wp-image-1721 size-full\" src=\"https:\/\/zenmedinc.com\/blog\/wp-content\/uploads\/2024\/08\/a1.jpg\" alt=\"\" width=\"572\" height=\"642\"><br>\n<img decoding=\"async\" class=\"aligncenter size-full wp-image-1722\" src=\"https:\/\/zenmedinc.com\/blog\/wp-content\/uploads\/2024\/08\/a2.jpg\" alt=\"\" width=\"584\" height=\"670\"><img decoding=\"async\" class=\"aligncenter wp-image-1723 size-full\" src=\"https:\/\/zenmedinc.com\/blog\/wp-content\/uploads\/2024\/08\/a3.jpg\" alt=\"\" width=\"516\" height=\"640\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-1724\" src=\"https:\/\/zenmedinc.com\/blog\/wp-content\/uploads\/2024\/08\/a4.jpg\" alt=\"\" width=\"588\" height=\"584\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-1727 size-full aligncenter\" src=\"https:\/\/zenmedinc.com\/blog\/wp-content\/uploads\/2024\/08\/a6.jpg\" alt=\"\" width=\"542\" height=\"422\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-1728 size-full aligncenter\" src=\"https:\/\/zenmedinc.com\/blog\/wp-content\/uploads\/2024\/08\/a7.jpg\" alt=\"\" width=\"542\" height=\"642\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-1725 size-full\" src=\"https:\/\/zenmedinc.com\/blog\/wp-content\/uploads\/2024\/08\/a5.jpg\" alt=\"\" width=\"546\" height=\"580\"><\/p>\n<p><span style=\"font-size: small; color: #000000;\">&nbsp;<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Well, here we are into the third quarter of 2024 and by now, if you\u2019re a provider in private practice, you (and any other providers that may be working for you\/with you), should have performed an Annual Wellness Visit (AWV), on most, if not all your active patients and hopefully,<\/p>\n","protected":false},"author":2,"featured_media":1776,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[16],"tags":[22,24,23],"class_list":["post-1709","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicare","tag-annual-wellness-visit","tag-sdoh","tag-social-determinants-of-health-screening"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>BREAKING DOWN THE SDOH AND HOW IT APPLIES TO THE ANNUAL WELLNESS VISIT IN 2024 - ZenMed Solutions Inc<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/zenmedinc.com\/blog\/annual-wellness-visit\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" 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