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Medicare annual wellness visit reminders: who is due, when to book, and messages to send
Ayush Gondley · 26 October 2026 · 6 min read
The reminder goes out at 11 months, so the visit lands just after 12.
Key takeaways
- Medicare covers the annual wellness visit once every 12 months. Under 42 CFR 410.15 it is not paid if the patient had an annual wellness visit or a Welcome to Medicare visit within the past 12 months, or is still in their first 12 months of Part B.
- The patient pays nothing when the provider accepts assignment, and the Part B deductible does not apply. Other tests or services in the same visit can cost them coinsurance.
- It is not a routine physical exam, which is the most common surprise for patients. The reminder should say what the visit is: a health risk questionnaire, a review of history and medicines, and a written plan of screenings.
- Our recommendation is to send the reminder at 11 months and book the visit for a date just past the 12-month mark, checking the date of the last visit before booking.
The annual wellness visit is a covered visit most Medicare patients would take if someone asked them at the right time. The practice's job is mostly timing: ask too early and the claim is denied, ask too late and the patient goes another year without a prevention plan. A reminder sent on a date worked out from the last visit fixes both.
Who is due
Medicare's rule is in 42 CFR 410.15. A patient can have an annual wellness visit when they are no longer within 12 months of the start of their first Part B coverage, and have not had an annual wellness visit or a Welcome to Medicare preventive visit within the past 12 months.1 Medicare.gov tells patients the same thing: once every 12 months, and the first one cannot be within 12 months of joining Part B or of the Welcome to Medicare visit.2
That leaves three groups on your list:
| The patient | Due for |
|---|---|
| In their first 12 months of Part B | The Welcome to Medicare preventive visit, not an annual wellness visit |
| Past their first 12 months, never had one | A first annual wellness visit, at least 12 months after any Welcome to Medicare visit |
| Had one before | The next one, 12 months or more after the last |
CMS's compliance tip for providers repeats the 12-month rule and reports a 24.5% overpayment rate for subsequent annual wellness visits in the 2024 reporting period.3 Our recommendation is to check the date of the patient's last visit, at your practice or anywhere else, before you book.
What the visit is, and what it is not
The first annual wellness visit includes a health risk assessment, the patient's medical and family history, a list of their current providers, height, weight, body mass index and blood pressure, a check for cognitive impairment, a depression screen, a review of functional ability and safety, a written screening schedule for the next 5 to 10 years, and personalized health advice. Advance care planning is offered only if the patient wants it.1
Medicare.gov is plain about the thing patients most often get wrong: it is not a routine physical exam.2 A patient who expects a physical and gets a questionnaire feels misled, and a patient who asks for more during the visit may be billed for it. Say it in the reminder.
What the patient pays
Medicare.gov says the patient pays nothing for the visit if the provider accepts assignment, and the Part B deductible does not apply. If other tests or services are done during the same visit and are not part of the wellness visit, the patient may owe coinsurance, and the deductible may apply.2 Our recommendation is to say both in the confirmation, so a separate charge for a problem raised during the visit is no surprise.
When to send the reminder
Our recommendation is a short sequence, keyed to the date of each patient's last annual wellness visit or Welcome to Medicare visit:
- At 11 months: the invitation, with times that fall after the 12-month mark.
- Two weeks later, if no reply: one follow-up.
- Two days before the visit: the confirmation, with what to bring and what the visit is.
For patients who have never had one, run the same sequence from the date their first 12 months of Part B end. A patient who turns 65 in the spring gets the Welcome to Medicare visit message instead.
Messages you can copy
Replace the words in brackets. Keep texts short: the practice's name, the purpose, and how to reply. For the rules on what an appointment text may say, see our appointment reminder texts guide.
The invitation · 11 months after the last wellness visit
Hello [Name], this is [Practice]. You are due for your Medicare annual wellness visit after [date]. Medicare covers it once a year, and you pay nothing for the visit itself. Reply with a day that suits you, or call [phone].
The follow-up · two weeks later, only if there was no reply
Hello [Name], a reminder from [Practice] that your yearly wellness visit can be booked for any day after [date]. It takes about [length]. Reply YES and we will call you with times.
The confirmation · two days before the visit
Hello [Name], your annual wellness visit at [Practice] is on [day] at [time]. It is a review of your health and a plan of screenings, not a full physical exam. Please bring your medicines or a list of them, and the names of any other doctors you see. If we treat anything else during the visit, there may be a separate charge.
New to Medicare · in the first months of Part B
Hello [Name], welcome to Medicare. In your first 12 months you can have a Welcome to Medicare preventive visit, and after that a yearly wellness visit. Reply or call [phone] and we will book your first one.
The same reminder sequence works for no-shows and recalls, as in our no-show policy guide. New patients who join for Medicare care start with our new patient intake checklist.
What can run by itself
- The due date for each patient, worked out from the last wellness visit or Welcome to Medicare visit in your records, or the end of their first year of Part B.
- The invitation and one follow-up, sent on those dates and stopped as soon as the patient books or replies.
- A check before booking that the date is past the 12-month mark, so the claim is not denied.
- The confirmation, with what to bring and what the visit is, two days before, as in our front desk automation guide.
What stays with your team
- Eligibility questions, such as a visit at another practice that your records do not show, which a call to the patient or a check with Medicare settles.
- The visit itself, and the prevention plan that comes out of it.
- Patients who decline, who should be asked again next year and not every month.
More of what we write for practices is on the blog.
Questions practices ask
How often does Medicare pay for an annual wellness visit?
Once every 12 months. Under 42 CFR 410.15 it is not paid if the patient had an annual wellness visit or a Welcome to Medicare visit within the past 12 months.
Can a new Medicare patient have an annual wellness visit?
Not in their first 12 months of Part B. In that year they can have the Welcome to Medicare preventive visit, and the annual wellness visit after that.
Does the patient pay for the annual wellness visit?
No, if the provider accepts assignment, and the Part B deductible does not apply. Other tests or services in the same visit may cost them coinsurance.
Is the annual wellness visit a physical?
No. Medicare.gov says it is not a routine physical exam. It is a health risk assessment, a review of history and medicines, routine measurements and a written plan of screenings.
When should the reminder go out?
Our recommendation is 11 months after the last visit, offering dates past the 12-month mark, with one follow-up and a confirmation two days before.
Sources
- Code of Federal Regulations, 42 CFR 410.15, annual wellness visits providing personalized prevention plan services.
- Medicare.gov, Yearly "Wellness" visits.
- Centers for Medicare & Medicaid Services, Medicare Learning Network, Medicare provider compliance tips: annual wellness visits.
About the author
Ayush Gondley founded Gondley Consulting, which automates front-desk work for small US medical, therapy and veterinary practices. Before that he was a marine engineer at Maersk, keeping complex systems running at sea. Gondley Consulting on LinkedIn
