Initial Preventive Physical Examination (IPPE) - JF Part A

HCPCS/CPT Codes

• G0402 - IPPE
• G0403 - EKG for IPPE
• G0404 - EKG tracing for IPPE
• G0405 - EKG interpret & report for IPPE

Frequency

Once in a lifetime and must be furnished no later than 12 months after effective date of first Medicare Part B coverage period

Coverage

• All new Medicare beneficiaries within first 12 months of their first Medicare Part B coverage period
• Performed by Physician, Physician Assistant (PA), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS)

Payment

• G0402 - Copayment/coinsurance waived; Deductible waived
• G0403, G0404 and G0405 - Copayment/coinsurance applies; Deductible applies

Noridian Medicare Portal

Yes - G0402, G0403, G0404, G0405

Resources

• CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 18, Section 80
• CMS Medicare Preventive Services
• MLN Medicare Wellness Visits Educational Tool