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HCPCS G0439: Annual Wellness Visit with Personalized Prevention Plan

HCPCS Level II code G0439 designates an annual wellness visit that includes a personalized prevention plan of service (PPS) and is used for subsequent visits. This preventive-care code is nationally significant because it supports structured, longitudinal prevention planning for Medicare beneficiaries and other populations who receive covered wellness services. The code underpins efforts to document prevention-focused encounters and Medicare-aligned care planning across ambulatory settings.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of reimbursement and billing benchmarks, common billing practices, policy and coverage considerations relevant to wellness and PPS services, and the clinical context for when G0439 is reported. The publication summarizes payer coverage patterns, notable policy updates affecting preventive visit billing, and practical considerations for service lines delivering annual wellness visits. Where input data is missing, the document notes that data is not available in the input. This national-focused brief is intended to inform coding, billing oversight, and operational planning related to preventive annual wellness visits with PPS documentation.

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Billing Code Overview

HCPCS Level II code G0439 represents an annual wellness visit that includes a personalized prevention plan of service (PPS) and is billed for a subsequent visit. The service type is preventive, wellness visit with care planning. The typical site of service is ambulatory outpatient clinics or primary care offices where clinicians conduct preventative care visits and update personalized prevention plans.

Data not available in the input.

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HCPCS G0439: Annual Wellness Visit with Personalized Prevention Plan

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Get alerted when payer policies referencing G0439 are released or updated.

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Billing Code Overview

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Clinical & Coding Specifications

Clinical Context

An established Medicare beneficiary returns to their primary care clinic for an annual wellness visit (subsequent visit) that updates the patient’s personalized prevention plan of service (PPS). The patient is an 72-year-old with hypertension, type 2 diabetes in good control, and a history of hyperlipidemia. The clinical workflow begins with pre-visit medication reconciliation and review of prior screening results. At arrival, nursing staff measure vitals, update problem list and medication list, and screen for falls, depression, cognitive impairment, and immunization status. The clinician conducts a focused history and review of health risk factors since the prior AWV, reviews preventive screening needs (colon cancer screening, pneumococcal and influenza vaccine status), updates the PPS, documents preventive services and referrals, and counsels on lifestyle risks. If appropriate, orders for laboratory screening or referrals are placed, and the clinician documents the elements required for an annual wellness visit subsequent to the initial AWV, billed with G0439.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable E/M service by the same physician on the same day	When a distinct evaluation and management service is performed in addition to the AWV on the same day.
`26`	Professional component	When reporting only the professional component of a service (rare for AWV, applicable to ancillary services billed separately).
`59`	Distinct procedural service	To indicate a distinct service or procedure not normally reported together, when applicable for separately billed preventive procedures.
`25`	Note: Duplicate entry removed in practice; listed once above	When used as described.
`52`	Reduced services	When the service provided is substantially reduced and payer allows a reduced service modifier.
`53`	Discontinued procedure	If the AWV process was started but discontinued for patient safety reasons.
`24`	Unrelated E/M service by the same physician during a postoperative period	If a patient is in a global surgical period and AWV is unrelated to the surgery.
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	When the subsequent AWV is performed via live telehealth that meets payer requirements.
`GT`	Via interactive audio and video telecommunication systems	When applicable for telehealth AWV, depending on payer-specific telehealth modifier preference.
`GA`	Waiver of liability statement on file (patient refused)	When ABN-like waiver is on file for non-covered components per payer policy.
`GZ`	Item or service expected to be denied as not reasonable and necessary	When provider anticipates denial for non-covered components of the visit.
`25`	(Third listing removed)	Modifier `25` is commonly used; duplicate entries avoided.
`TC`	Technical component	When reporting only the technical component of an ancillary service performed in conjunction with the AWV.

Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Primary providers who commonly perform and bill AWVs.
`207R00000X`	Internal Medicine	Commonly provides AWVs for adult and geriatric patients.
`261QM0800X`	Geriatric Medicine	Specialists who manage preventive care for older adults and perform AWVs.
`208000000X`	General Practice	Often delivers preventive visits in community settings.
`207L00000X`	Nurse Practitioner	Advanced practice clinicians who frequently perform AWVs under appropriate state scope.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z00.00`	Encounter for general adult medical examination without abnormal findings	Common reason to document and bill an annual wellness visit when no acute issues are found.
`Z00.01`	Encounter for general adult medical examination with abnormal findings	Used when the AWV identifies abnormal findings requiring follow-up.
`Z13.6`	Encounter for screening for cardiovascular disorders	Relevant for risk assessment during AWV in patients with hypertension or hyperlipidemia.
`Z13.9`	Encounter for screening, unspecified	General screening designation when specific screening code is not used.
`Z79.899`	Other long term (current) drug therapy	Documents ongoing chronic medication use reviewed during the AWV.
`Z91.81`	History of falling	Falls risk screening is a standard AWV component for older adults.
`Z68.25`	Body mass index (BMI) 25.0-25.9, adult	Weight and BMI assessment and counseling are routine parts of the AWV.
`Z71.3`	Dietary counseling and surveillance	Nutrition and lifestyle counseling commonly occur and may be documented during the AWV.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99385`	Initial comprehensive preventive medicine evaluation, new patient (age 18–39)	Not directly used with `G0439`; listed for preventive medicine comparison when a comprehensive initial preventive visit is performed for a new patient.
`99386`	Initial comprehensive preventive medicine evaluation, new patient (age 40–64)	Same as above for older adult new patients; contrasts with Medicare AWV codes.
`99395`	Periodic comprehensive preventive medicine evaluation, established patient (age 18–39)	Alternative preventive visit code used for commercial payers; may be used when payor does not accept AWV-specific HCPCS.
`99396`	Periodic comprehensive preventive medicine evaluation, established patient (age 40–64)	Preventive visit CPT for established patients; used in non-Medicare contexts.
`99406`	Smoking and tobacco use cessation counseling, intermediate (3–10 minutes)	Common counseling procedure performed during an AWV and may be billed separately if payer allows.
`90471`	Immunization administration (per vaccine)	Vaccinations identified as needed during AWV are administered and billed separately with appropriate administration codes.

HCPCS G9490: Home Visit Assessment for Non-Homebound Patients

HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

HCPCS G0008: Influenza Virus Vaccine Administration

HCPCS-G0009-PNEUMOCOCCAL-VACCINE-ADMINISTRATION

HCPCS G0009: Administration of Pneumococcal Vaccine

HCPCS-G0010-HEPATITIS-B-VACCINE-ADMINISTRATION

HCPCS G0010: Administration of Hepatitis B Vaccine

HCPCS-G0011-PREP-COUNSELING-HIV-RISK-REDUCTION-ADHERENCE

HCPCS G0011: Individual PrEP Counseling, HIV Risk Assessment

HCPCS-G0012-PRE-EXPOSURE-PROPHYLAXIS-INJECTION-HIV-PREVENTION

HCPCS G0012: Injection of Pre-Exposure Prophylaxis (PrEP) for HIV Prevention

HCPCS-G0013-PREP-INDIVIDUAL-COUNSELING-HIV-RISK-REDUCTION

HCPCS G0013: Individual PrEP Counseling and HIV Risk Assessment

HCPCS-G0017-PSYCHOTHERAPY-CRISIS-FIRST-60-MINUTES-NON-OFFICE

HCPCS G0017: Psychotherapy for Crisis, First 60 Minutes

HCPCS-G0018-PSYCHOTHERAPY-CRISIS-ADDITIONAL-30-MINUTES-NON-OFFICE

HCPCS G0018: Psychotherapy for Crisis, Additional 30 Minutes

HCPCS-G0019-COMMUNITY-HEALTH-INTEGRATION-SDOH-CARE-COORDINATION

HCPCS G0019: Community Health Integration for Social Determinants of Health

Showing 1–10 of 1996

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable E/M service by the same physician on the same day	When a distinct evaluation and management service is performed in addition to the AWV on the same day.
`26`	Professional component	When reporting only the professional component of a service (rare for AWV, applicable to ancillary services billed separately).
`59`	Distinct procedural service	To indicate a distinct service or procedure not normally reported together, when applicable for separately billed preventive procedures.
`25`	Note: Duplicate entry removed in practice; listed once above	When used as described.
`52`	Reduced services	When the service provided is substantially reduced and payer allows a reduced service modifier.
`53`	Discontinued procedure	If the AWV process was started but discontinued for patient safety reasons.
`24`	Unrelated E/M service by the same physician during a postoperative period	If a patient is in a global surgical period and AWV is unrelated to the surgery.
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	When the subsequent AWV is performed via live telehealth that meets payer requirements.
`GT`	Via interactive audio and video telecommunication systems	When applicable for telehealth AWV, depending on payer-specific telehealth modifier preference.
`GA`	Waiver of liability statement on file (patient refused)	When ABN-like waiver is on file for non-covered components per payer policy.
`GZ`	Item or service expected to be denied as not reasonable and necessary	When provider anticipates denial for non-covered components of the visit.
`25`	(Third listing removed)	Modifier `25` is commonly used; duplicate entries avoided.
`TC`	Technical component	When reporting only the technical component of an ancillary service performed in conjunction with the AWV.

Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Primary providers who commonly perform and bill AWVs.
`207R00000X`	Internal Medicine	Commonly provides AWVs for adult and geriatric patients.
`261QM0800X`	Geriatric Medicine	Specialists who manage preventive care for older adults and perform AWVs.
`208000000X`	General Practice	Often delivers preventive visits in community settings.
`207L00000X`	Nurse Practitioner	Advanced practice clinicians who frequently perform AWVs under appropriate state scope.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z00.00`	Encounter for general adult medical examination without abnormal findings	Common reason to document and bill an annual wellness visit when no acute issues are found.
`Z00.01`	Encounter for general adult medical examination with abnormal findings	Used when the AWV identifies abnormal findings requiring follow-up.
`Z13.6`	Encounter for screening for cardiovascular disorders	Relevant for risk assessment during AWV in patients with hypertension or hyperlipidemia.
`Z13.9`	Encounter for screening, unspecified	General screening designation when specific screening code is not used.
`Z79.899`	Other long term (current) drug therapy	Documents ongoing chronic medication use reviewed during the AWV.
`Z91.81`	History of falling	Falls risk screening is a standard AWV component for older adults.
`Z68.25`	Body mass index (BMI) 25.0-25.9, adult	Weight and BMI assessment and counseling are routine parts of the AWV.
`Z71.3`	Dietary counseling and surveillance	Nutrition and lifestyle counseling commonly occur and may be documented during the AWV.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99385`	Initial comprehensive preventive medicine evaluation, new patient (age 18–39)	Not directly used with `G0439`; listed for preventive medicine comparison when a comprehensive initial preventive visit is performed for a new patient.
`99386`	Initial comprehensive preventive medicine evaluation, new patient (age 40–64)	Same as above for older adult new patients; contrasts with Medicare AWV codes.
`99395`	Periodic comprehensive preventive medicine evaluation, established patient (age 18–39)	Alternative preventive visit code used for commercial payers; may be used when payor does not accept AWV-specific HCPCS.
`99396`	Periodic comprehensive preventive medicine evaluation, established patient (age 40–64)	Preventive visit CPT for established patients; used in non-Medicare contexts.
`99406`	Smoking and tobacco use cessation counseling, intermediate (3–10 minutes)	Common counseling procedure performed during an AWV and may be billed separately if payer allows.
`90471`	Immunization administration (per vaccine)	Vaccinations identified as needed during AWV are administered and billed separately with appropriate administration codes.

HCPCS G9490: Home Visit Assessment for Non-Homebound Patients

HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

HCPCS G0008: Influenza Virus Vaccine Administration

HCPCS-G0009-PNEUMOCOCCAL-VACCINE-ADMINISTRATION

HCPCS G0009: Administration of Pneumococcal Vaccine

HCPCS-G0010-HEPATITIS-B-VACCINE-ADMINISTRATION

HCPCS G0010: Administration of Hepatitis B Vaccine

HCPCS-G0011-PREP-COUNSELING-HIV-RISK-REDUCTION-ADHERENCE

HCPCS G0011: Individual PrEP Counseling, HIV Risk Assessment

HCPCS-G0012-PRE-EXPOSURE-PROPHYLAXIS-INJECTION-HIV-PREVENTION

HCPCS G0012: Injection of Pre-Exposure Prophylaxis (PrEP) for HIV Prevention

HCPCS-G0013-PREP-INDIVIDUAL-COUNSELING-HIV-RISK-REDUCTION

HCPCS G0013: Individual PrEP Counseling and HIV Risk Assessment

HCPCS-G0017-PSYCHOTHERAPY-CRISIS-FIRST-60-MINUTES-NON-OFFICE

HCPCS G0017: Psychotherapy for Crisis, First 60 Minutes

HCPCS-G0018-PSYCHOTHERAPY-CRISIS-ADDITIONAL-30-MINUTES-NON-OFFICE

HCPCS G0018: Psychotherapy for Crisis, Additional 30 Minutes

HCPCS-G0019-COMMUNITY-HEALTH-INTEGRATION-SDOH-CARE-COORDINATION

HCPCS G0019: Community Health Integration for Social Determinants of Health

Showing 1–10 of 1996

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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HCPCS G0439: Annual Wellness Visit with Personalized Prevention Plan

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Billing Code Overview

OpenPayer

HCPCS G0439: Annual Wellness Visit with Personalized Prevention Plan

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

HCPCS G0439: Annual Wellness Visit with Personalized Prevention Plan

Sign up for hcpcs G0439 policy alerts

Billing Code Overview

HCPCS G0439: Annual Wellness Visit with Personalized Prevention Plan

Sign up for hcpcs G0439 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code G0439 represent and when is it used?

Which modifiers are commonly associated with billing G0439 and when would they apply?

Are there CPT codes or other services commonly billed alongside or instead of G0439?

Which ICD‑10 diagnosis codes are relevant when documenting an annual wellness visit with PPS?

What clinical activities and documentation are described for an AWV billed with G0439?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code G0439 represent and when is it used?

Which modifiers are commonly associated with billing G0439 and when would they apply?

Are there CPT codes or other services commonly billed alongside or instead of G0439?

Which ICD‑10 diagnosis codes are relevant when documenting an annual wellness visit with PPS?

What clinical activities and documentation are described for an AWV billed with G0439?

References