CPT code G0402, G0403, G0404, G0405 and coverage frequency

Preventive Physical Examination (IPPE)

Also known as the “Welcome to Medicare Preventive Visit” HCPCS/CPT Codes

G0402 – IPPE
G0403 – EKG for IPPE
G0404 – EKG tracing for IPPE
G0405 – EKG interpret & report for IPPE

ICD-10-CM Codes

See https://www.cms.gov/Medicare/Coverage/CoverageGenInfo/ICD10.html for individual Change Requests (CRs) and coding translations for ICD-10


Who Is Covered

All new Medicare beneficiaries who are within the first 12 months of their first Medicare Part B coverage period

Frequency

Once in a lifetime

Must furnish no later than 12 months after the effective date of the first Medicare Part B coverage period


Beneficiary Pays

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