G0402 - Welcome to Medicare physical exam for new beneficiaries
Healthcare Common Procedure Coding System
What is a HCPCS Code?
HCPCS (Healthcare Common Procedure Coding System) codes are used to identify medical procedures, supplies, and services for billing purposes. These codes help standardize how healthcare services are reported and billed across different providers and insurance companies.
Detailed Description
This is a comprehensive physical examination specifically designed for people who are new to Medicare. It's a face-to-face visit with your healthcare provider that must occur within your first 12 months of Medicare enrollment. This exam is different from a regular annual physical and focuses on establishing your baseline health status, reviewing your medical history, and creating a personalized prevention plan. It's sometimes called the 'Welcome to Medicare' exam and is a one-time benefit available only to new Medicare beneficiaries.
Additional Information
This is a Medicare-specific benefit distinct from regular physical exams. It's covered by Medicare Part B and focuses on prevention and establishing your health baseline rather than treating existing conditions.
Category
Preventive Care
Medical Specialty
Primary Care/Family Medicine
Expected Costs
Your actual cost will depend on your insurance coverage, provider location, and specific circumstances.
What's Required Before This
- Must be a new Medicare beneficiary
- Must be scheduled within first 12 months of Medicare enrollment
- One-time benefit only
What to Expect After
- Annual wellness visits (separate from this initial exam)
- Follow-up on any health concerns identified during exam
- Implementation of personalized prevention plan
Why Understanding This Code Matters
On Your Medical Bill
This code appears on your medical bills to identify the specific service, procedure, drug, or medical diagnosis you received. Understanding what it means helps you verify you're being charged correctly and know what to expect.
For Your Health
Knowing what this code represents helps you understand your treatment plan, ask better questions during appointments, and track your healthcare journey more effectively.
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