HCPCS G0439: Subsequent Annual Wellness Visit
HCPCS G0439 is the subsequent Medicare Annual Wellness Visit (AWV), billed every 12 months after the initial AWV. In 2026 Medicare pays about $137.61 (4.12 total RVUs times the $33.4009 conversion factor), the same in facility and non-facility settings.
- Code type
- Subsequent Annual Wellness Visit (AWV)
- 2026 non-facility
- $137.61 (4.12 RVUs)
- 2026 facility
- $137.61 (4.12 RVUs)
- Frequency
- Once every 12 months after initial AWV
What is HCPCS G0439 used for?
G0439 is the subsequent Medicare Annual Wellness Visit (AWV), the recurring prevention-planning visit billed each year after the initial AWV. It updates the health risk assessment and the personalized prevention plan, refreshes the screening schedule, and re-checks cognitive and functional status. It is the workhorse of a Medicare preventive-visit program at scale.
Medicare allows one AWV per 12-month period, and G0439 is used for every AWV after the initial G0438. Eligibility resets on the first day of the same calendar month the following year, not exactly 365 days out, which is the timing detail that most often trips up rebilling. As a preventive service it carries the structured prevention-planning content rather than a hands-on physical exam.
How much does G0439 pay in 2026?
G0439 carries 4.12 total RVUs in both settings. At the 2026 conversion factor of $33.4009 that is about $137.61, facility and non-facility alike, with no patient cost-sharing as a covered preventive service. It pays less than the initial G0438 because the prevention plan already exists and is being updated rather than created. Model it on the Medicare fee calculator.
The 12-month rule and same-day add-ons
- Confirm at least 12 months since the last AWV (a shorter interval is a denial).
- Confirm the patient already had an initial AWV (G0438) or a prior G0439.
- If a separate problem is addressed, add a problem E/M with modifier 25.
Example: a patient in for a yearly wellness update who also reports worsening knee pain generates a G0439 plus a modifier-25 99214 when the problem work is separately documented, capturing both the ~$137.61 wellness payment and the problem E/M rather than folding the complaint into the AWV for free.
Frequently asked questions
Bill G0439 for any Annual Wellness Visit after the initial one, provided at least 12 months have passed since the last AWV (initial or subsequent). Medicare allows one AWV per 12-month period; the patient becomes eligible again on the first day of the same calendar month the following year.
The 2026 national allowed amount is about $137.61 (4.12 total RVUs times $33.4009), the same in facility and non-facility settings. It pays less than the initial AWV (G0438) because the prevention plan already exists and is being updated rather than created.
Yes. When a distinct, medically necessary problem is addressed at the same encounter, report the problem E/M (99202-99215) with modifier 25 alongside G0439. The AWV covers the preventive update; the E/M covers the separate problem work. Document each service so the modifier 25 is supported.
Sources & further reading
Reviewed by the ImmediCare Solutions RCM team
Certified billers and coders handling claims across 50+ specialties nationwide. This entry is reviewed against current payer policy and CMS rules. Last review: Jul 5, 2026.
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