What your uncompleted wellness visits are worth.
A free calculator for the Medicare annual wellness visit completion gap. Enter your panel and what you billed last year, and see the difference in dollars.
2026 national averagesRuns in your browserNothing is sent anywhere
The gap, in dollars, in about thirty seconds.
The annual wellness visit pays well, costs the patient nothing, and is the qualifying visit that makes chronic care management enrollment possible. Most practices complete it for a minority of their eligible panel, and almost none of them know the size of the gap in dollars.
This calculates it. Everything updates live, every assumption is editable, and nothing is sent anywhere.
Your panel, your rates.
Defaults are 2026 national averages. Overwrite any of them with your own carrier's amounts.
Traditional Medicare. Advantage patients are contracted separately and are not counted here.
If you do not know, most practices guess high. Pull the count of G0438 and G0439 claims you billed last year.
What you could reach in year one if the visit stopped competing for an examination room.
2026 national average. Your locality will differ.
The recurring one, and the one most practices leave unbilled.
Those visits pay the initial rate. Everyone else pays the subsequent rate.
99497, about $85. The patient owes nothing when it is done on the same day as the wellness visit.
G0444, about $17, separately reportable alongside a subsequent visit only.
What this number is, and is not.
These are estimates, and they are not a quote. Payment amounts are 2026 national averages under the Medicare Physician Fee Schedule and are adjusted by geography, so your locality will differ. Add-on codes have their own coverage and documentation rules. Check the CMS fee schedule lookup for your own carrier before making a decision on these numbers. Nothing here is billing, coding, or legal advice for your practice.
About the arithmetic.
Where do the default rates come from?
They are 2026 national averages under the Medicare Physician Fee Schedule: about $174 for an initial annual wellness visit (G0438) and about $138 for each subsequent one (G0439). Both are adjusted by locality and updated every January, so treat the defaults as a starting point and overwrite them with your own carrier's amounts.
What completion rate is realistic?
Practices consistently overestimate their current rate, which is why the calculator asks you to pull the actual count of G0438 and G0439 claims rather than estimate. The target slider is deliberately yours to set: what is achievable depends far more on whether the visit has to occupy an examination room than on anything clinical.
Why are advance care planning and the depression screen included?
Because they are the two add-ons most often left unbilled, and both are legitimate on the same day. Advance care planning (99497) pays roughly $85 and carries no patient cost sharing when furnished on the same day as the wellness visit. The depression screen (G0444) pays roughly $17 and is separately reportable alongside a subsequent visit, so the calculator scales it by the share of visits that are not initial ones.
Set either slider to zero if you would rather see the visit revenue alone.
Does this include care management revenue?
No, deliberately. The wellness visit is a once-a-year payment. The recurring money is in chronic care management and advanced primary care management, which pay monthly and for which the wellness visit is a qualifying visit. Mixing them would flatter the number. Care management is costed separately.
Is any of this sent anywhere?
No. The calculator runs entirely in your browser. Nothing is transmitted, nothing is stored, and there is no form to fill in. Reload the page and it resets.
Where the defaults come from.
- CMS Physician Fee Schedule lookup
- 42 CFR 410.15, annual wellness visit
- CMS Medicare Wellness Visits, MLN6775421
- Medicare.gov yearly wellness visits
Rates reviewed August 2026 against the 2026 Medicare Physician Fee Schedule. National averages, adjusted by locality, updated each January.
Bring the number to a fifteen minute call.
We will run the same arithmetic against your real locality rather than a national average, and tell you what closing the gap would actually cost.
Visit workflow, supervision model, and a sample completed AWV note.
Ask and we will send it the same day, with the reimbursement figures run against your own locality rather than a national average.