Preventive care
G0439 — Annual wellness visit, personalized prevention plan; subsequent visit
This Medicare HCPCS code covers every Annual Wellness Visit after the first one (G0438).
- Typical setting: Doctor's office
- National avg charge (illustrative): $100-$130 Medicare allowed (approx. $111 national Medicare average; $0 patient cost when provider accepts assignment)
- Most-disputed reason: Using G0439 before G0438: billing G0439 for a patient who has never had a G0438 AWV is incorrect sequencing (G0439 requires a prior initial AWV)
What it means
What G0439 actually means
This Medicare HCPCS code covers every Annual Wellness Visit after the first one (G0438). It is available once every 12 months and updates the prevention plan established at the initial AWV. Like G0438, it is fully covered with no patient cost-sharing when the provider accepts assignment, and it includes a health risk assessment update, cognitive screening, and depression screening.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Using G0439 before G0438: billing G0439 for a patient who has never had a G0438 AWV is incorrect sequencing (G0439 requires a prior initial AWV)
- Frequency error: billing G0439 more often than once per 12 months — payers will deny a second AWV billed within the same 12-month period
- Bundling with additional services without modifier: billing separately for routine elements (e.g., blood pressure measurement) that are already included in the AWV package
If you see G0439 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on G0439 often also see these adjacent codes on the same bill.
HCPCS
G0011 — Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes
Hiv prep counsel, md 15-30m
HCPCS
G0012 — Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle
Injection of hiv prep drug
Related BillBusted guides
Plain-English reads if you see G0439 on a bill.
G0439 FAQ
Plain-English answers.
What does G0439 usually cost?
$100-$130 Medicare allowed (approx. $111 national Medicare average; $0 patient cost when provider accepts assignment). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on G0439?
Using G0439 before G0438: billing G0439 for a patient who has never had a G0438 AWV is incorrect sequencing (G0439 requires a prior initial AWV)
What should I do if I see G0439 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to G0439 before paying.
Don't pay G0439 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.