HCPCS code G0439: Annual wellness visit, subsequent visit2026 Medicare rate & RVUs in Texas
A subsequent Medicare annual wellness visit updates the prevention plan after an initial AWV, once 11 full calendar months have passed since the previous AWV.
Medicare pays $131.08–$141.26 for G0439 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What G0439 covers
The subsequent annual wellness visit is a Medicare Part B preventive benefit. It updates the health risk assessment, medical and family history, provider and supplier list, and measurements such as weight and blood pressure. It also includes cognitive impairment assessment, an updated written screening schedule and risk-factor list, and personalized health advice with referrals as appropriate. Physicians, nurse practitioners, physician assistants, and clinical nurse specialists commonly furnish it in primary care offices. A team that includes qualified professionals such as health educators or registered dietitians may furnish it under physician direct supervision. It is not a comprehensive physical examination.
Report G0439 after the beneficiary has received an initial AWV (G0438) and 11 full calendar months have passed since the previous AWV. Document the updated assessment and the revised prevention plan provided to the patient. Medicare waives the deductible and coinsurance for the AWV. If the clinician also evaluates a significant, separately identifiable problem, report the appropriate E/M code with modifier 25; normal cost sharing applies to that E/M service.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Billing guides for G0439: Annual wellness visit codes
Where G0439 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$131.08 to $141.26
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $141.26 | Unavailable |
| Beaumont, TX | $131.08 | Unavailable |
| Brazoria, TX | $136.55 | Unavailable |
| Dallas, TX | $137.30 | Unavailable |
| Fort Worth, TX | $136.66 | Unavailable |
| Galveston, TX | $136.89 | Unavailable |
| Houston, TX | $139.27 | Unavailable |
| Rest of Texas | $133.66 | Unavailable |
How the G0439 rate is calculated
Each of G0439’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · G0439
RVUs × geographic indexes × conversion factor
Work1.92
1.92 RVUs× 1.000 GPCI
Practice expense2.07
2.07 RVUs× 1.000 GPCI
Malpractice0.13
0.13 RVUs× 1.000 GPCI
Adjusted RVUs
4.1200
Conversion factor
$33.4009
Medicare rate
$137.61
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G0439
G0439 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · G0439
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$137.61
Higher because the practice carries its own overhead.
G0439 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- G0438Annual wellness visitInitial visit, first AWV
- G0438 is the one-time initial AWV. G0439 updates the prevention plan at a later eligible AWV; both require a health risk assessment.
- G0402Welcome visitFirst 12 months of Part B
- G0402 is the one-time introductory preventive visit available during the first 12 months of Part B enrollment. It is not a substitute for G0439, which follows an initial AWV.
- 99397Preventive examEstablished patient, age 65+
- 99397 describes a comprehensive preventive medicine visit for patients 65 and older. Original Medicare does not cover routine preventive physical exams; G0439 covers the defined subsequent AWV instead.
G0439 billing questions
How do I choose between G0438 and G0439?
G0438 is the beneficiary's one-time initial AWV. Use G0439 for a later AWV after G0438, once 11 full calendar months have passed since the previous AWV; an IPPE alone does not qualify the beneficiary for G0439.
Can a problem-oriented E/M visit be billed on the same day?
Yes, if a significant, separately identifiable problem is evaluated and documented. Report the E/M code with modifier 25; normal cost sharing applies to that service.
Can advance care planning be billed with the subsequent AWV?
Yes. Advance care planning is optional at the AWV; report 99497 and, when the additional time requirement is met, 99498. Append modifier 33 to the advance care planning code when the same provider furnishes it on the AWV date so its deductible and coinsurance are waived.
Is annual depression screening separately billable with G0439?
G0444 may be reported with G0439 when the separate annual depression screening is performed and documented. CMS does not allow G0444 with the initial AWV, G0438.
Does the subsequent AWV require a physical exam?
No. It requires measurements, a health risk assessment, cognitive impairment assessment, and prevention-plan updates, but not a comprehensive physical examination.
What happens if G0439 is billed too soon?
Medicare may deny it for frequency if 11 full calendar months have not passed since the previous AWV. Check the prior AWV date and confirm that the beneficiary has received G0438.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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