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Primary care practices
An AWV workflow inside the EHR the practice already uses.
Healthcare / Annual Wellness Visit
Annual wellness visit software development
Medicare annual wellness visits only work when the right patients are booked, the visit type is right and every element is captured before the claim goes out. Agnotic Technologies builds annual wellness visit software for practices, medical groups and value-based care organizations.
IPPE · AWV
Visit type chosen from coverage history
Staff to clinician
Work split by who may do each step
Plan out
Prevention plan generated from the visit
Trusted by global innovators
Industry Overview
What is annual wellness visit software?
Annual wellness visit software runs a Medicare AWV program from start to finish: it checks eligibility and visit type, books and prepares patients, splits the visit between staff and clinician, produces the personalized prevention plan, applies billing and frequency edits, and reports results. Agnotic Technologies builds it for primary care practices, medical groups and value-based care teams.
Industry Challenges
Why do AWV programs lose visits?
The visit itself is short. The losses happen before and after it.
Wrong visit type: a patient in their first Part B year is booked for an AWV instead of the Welcome to Medicare visit, and the claim is denied.
Booked too early: the last visit was less than 12 months ago, which nobody checked because the history sits in another system.
Missing elements: cognitive assessment or the functional and safety review was not documented, so the visit does not meet the definition.
No plan handed over: the written screening schedule is drafted but never given to the patient or saved to the chart.
Outreach lists built by hand: staff export patient lists each month and miss people who changed coverage.
Clinician time on clerical work: the clinician enters height, weight and history that trained staff could have captured first.
Decision table
Which preventive visit is the patient due for?
The software has to choose between three visit types before anything is booked. This table shows the rule behind each one and what the software checks. How the 12 months are counted for billing is set from your payer guidance, not hard-coded.
| Visit type | Eligibility rule | HCPCS code | What the software checks |
|---|---|---|---|
| Initial preventive physical examination (Welcome to Medicare visit) | Within 1 year after the effective date of the first Part B coverage period (42 CFR 410.16) | G0402 | Part B effective date on file, and no earlier IPPE in the record |
| First annual wellness visit | Past the first 12 months of Part B coverage, with no IPPE or AWV in the past 12 months (42 CFR 410.15) | G0438 | No earlier first AWV, and the last IPPE or AWV date is outside the lookback |
| Subsequent annual wellness visit | Same eligibility, for a patient who has already had a first AWV (42 CFR 410.15) | G0439 | Date of the last AWV, and the updated history, provider list and screening schedule from it |
Our Approach
How do you split an AWV between staff and clinician?
Medicare lets a team of medical professionals under a physician's direct supervision furnish the visit. We build the workflow so each person does the part they are allowed to do, in order.
Before the visit
Staff confirm eligibility, send the health risk assessment, and update the list of current providers and suppliers.
Intake
A medical assistant records height, weight, body mass index and blood pressure, and starts the history from the previous visit.
Clinician review
The clinician reviews the assessment answers, the cognitive and depression findings, and the functional and safety review, then sets the plan.
Close out
The prevention plan goes to the patient, the referrals are sent, and the claim waits until every required element is marked complete.
Capabilities
What do we build into annual wellness visit software?
Modules for an AWV program, built alone or around your EHR.
Eligibility and visit type check
Part B dates and preventive visit history checked to pick IPPE, first AWV or subsequent AWV before booking.
Due list and outreach
Patients due for a visit found from coverage and visit history, with calls, texts and letters tracked.
Pre-visit preparation
The health risk assessment sent ahead of the visit and the previous history and provider list pulled forward.
Element tracker
Each required element shown as done or open during the visit, by role, so nothing is left for later.
Prevention plan builder
The written screening schedule and risk factor list drafted from the visit, edited by the clinician and handed to the patient.
Billing and frequency edits
Visit code matched to visit type, and claims held when a required element or the lookback check fails.
Program reporting
Visits due, booked, completed and billed, by clinic, clinician and payer.
AI help with documentation
Drafting the plan summary from the clinician's notes and screening answers, always reviewed and signed by the clinician.
How It Works
How does one AWV run, from due list to claim?
The path we build for each patient. Every step is visible on the program dashboard.
Find who is due
Coverage and visit history mark the patient as due and set the visit type.
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1
Book and prepare
Staff book the visit, send the health risk assessment and confirm the patient's other providers.
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2
Intake
Measurements and history updates are recorded by staff before the clinician joins.
03
3
Clinician visit
Assessment review, screening results and personalized health advice, with referrals where needed.
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4
Prevention plan
The written screening schedule and risk factor list are finalized and given to the patient.
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5
Claim and next due date
Billing edits pass, the claim goes out, and the next eligible date is set for outreach.
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6
Engineering Stack
Systems and standards behind AWV software
Chosen to fit your EHR and your outreach tools.
Clinical data
HL7 FHIR R4 Patient, Encounter, Observation and CarePlanFHIR Questionnaire and QuestionnaireResponseSMART on FHIR launch inside the EHR
Rules
Visit type and lookback rules with effective datesScreening recommendations loaded as dataClaim edit rules
Outreach
Text, voice and letter channelsPatient portal messagesCall lists for staff
Backend and infra
Node.jsPythonPostgreSQLAWS or Azure in your account
Health risk assessment
What must a health risk assessment for the Medicare AWV cover?
A health risk assessment for the Medicare AWV must collect self-reported information, take no more than 20 minutes, and cover six minimum topics set in 42 CFR 410.15. We build each topic as FHIR Questionnaire items with coded answers, and the form fails its build check if any topic has no item.
| HRA topic (42 CFR 410.15) | Example questions | FHIR item type and answers | LOINC codes | Who completes it |
|---|---|---|---|---|
| Demographic data | Date of birth, sex, race and ethnicity | date and choice items, pre-filled from the Patient record | 21112-8 Birth date; 76689-9 Sex assigned at birth; 32624-9 Race; 69490-1 Ethnicity | Registration staff, confirmed by the patient |
| Self-assessment of health status, frailty and physical functioning | In general, would you say your health is; do you have serious difficulty walking or climbing stairs | choice with a coded answer list; boolean | 61577-3; 69859-7 | Patient |
| Psychosocial risks | PHQ-2 depression items, stress level, loneliness or isolation, pain severity | choice items with scored answers; integer 0 to 10 for pain | 55757-9 PHQ-2; 93038-8 Stress level; 93159-2 Loneliness or isolation; 72514-3 Pain severity | Patient |
| Behavioral risks | Tobacco use, days of physical activity, alcohol use, plus seat belt use, home safety, nutrition, oral and sexual health | choice; integer; choice | 72166-2 Tobacco smoking status; 89555-7 Physical activity days; 72109-2 AUDIT-C; items with no LOINC code are marked as local codes | Patient |
| Activities of daily living | Difficulty dressing or bathing; falls in the past year | boolean, with follow-up items when the answer is yes | 69860-5; 52552-7 | Patient, with staff follow-up on positive answers |
| Instrumental activities of daily living | Difficulty doing errands such as shopping; transport to appointments; managing medicines and money | boolean; choice | 69861-3; 93030-5 | Patient, or a caregiver on the patient's behalf |
Measured Impact
What should an AWV program track?
Measures we build reporting around and review with your quality and billing leads.
Due
Eligible patients
Patients due for an IPPE or AWV, by clinic and clinician.
Booked
Outreach results
Patients contacted, booked and seen, by channel.
Complete
Element completion
Visits with every required element documented.
Billed
Claim outcome
Visits billed, held for an edit or denied, with the reason.
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Use Cases
Who commissions annual wellness visit software?
Teams that run AWVs at volume and need them right the first time.
02
Medical groups and IPAs
One program across many clinics, with central outreach.
03
Value-based care organizations
AWVs tied to care gap and quality work for attributed patients.
04
Medicare Advantage provider groups
Wellness visit scheduling across a large senior panel.
05
Home and virtual visit providers
Visit workflows for clinicians who see patients at home or on video.
06
AWV software for startups
Annual wellness visit software for startups selling to practices.
Integrations
Which systems does AWV software connect to?
The systems that hold coverage, the chart and the claim.
Chart and orders
EHR (Epic, athenahealth, eClinicalWorks, NextGen Healthcare and others)
Coverage
Eligibility services
Claims
Practice management and billing
Outreach
Patient messaging and portal
Follow-up
Referral and scheduling systems
Reporting
Population health and quality tools
What we check
Is your AWV workflow ready to scale?
What an annual wellness visit workflow needs before it scales. Any gap is a candidate for the first release.
Eligibility
- Part B effective date is on file for every Medicare patient
- Last IPPE and AWV dates are visible at booking
- Visit type is chosen by the system, not by memory
Visit
- Each required element shows as done or open
- Staff and clinician tasks are separated
- Cognitive and functional reviews are recorded in the chart
Plan and claim
- The written screening schedule is given to the patient
- Claims wait until required elements are complete
- The next due date feeds the outreach list
Compliance-First Development Services Backed by Global Standards
We build secure, scalable products designed for privacy, interoperability, and regulatory readiness from day one across every sector we serve.
Health Insurance Portability and Accountability Act
Protect PHI with privacy-first architecture, encrypted storage and transmission, and strict access controls.
Fast Healthcare Interoperability Resources
Enabling standardized health data exchange through standards-based API mappings.
Our Edge
Why Global Leaders Choose Us
We combine deep technical expertise with industry-specific knowledge to deliver solutions that aren't just functional, but transformational.
Enterprise-Grade Security
We implement rigorous security protocols and compliance standards (HIPAA, GDPR, SOC2) across all industrial solutions to protect sensitive data.
High-Performance Scaling
Our architectures are built to handle massive data loads and user bases, keeping performance steady whether you're serving ten or ten million.
Accelerated Time-to-Market
Using our suite of internal tools and proven frameworks, we cut setup work so your first release reaches users sooner.
Embedded AI Integration
Beyond simple wrappers, we build deep-learning integrations and predictive analytics directly into the core of your industry-specific workflows.
Engagement Model
How does an AWV software engagement work?
How to build annual wellness visit software one clinic at a time. Timing depends on scope; we agree a fixed first release on the scoping call.
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Scoping call
We review your EHR, how AWVs are booked and documented today, and where visits are lost.
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Workflow mapping
We sit in on visits, remotely or on site, and map each element to the person who does it.
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Fixed-scope first release
Eligibility checks, the due list and the element tracker for one clinic, with audit logging.
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Billing and plan
Prevention plan generation and claim edits added once the visit workflow is stable.
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Support
Rule updates each year when the Physician Fee Schedule or the AWV definition changes.
Facts and sources
Which rules define the annual wellness visit?
Short facts from Medicare regulations and the screening body the plan relies on, each linked to its primary source.
Medicare defines an eligible beneficiary for the annual wellness visit as someone no longer within 12 months after the effective date of their first Part B coverage period who has not received an initial preventive physical examination or an annual wellness visit within the past 12 months.
Source: 42 CFR 410.15(a) (eCFR)Medicare covers the initial preventive physical examination only when it is received not more than 1 year after the effective date of the beneficiary's first Part B coverage period.
Source: 42 CFR 410.16(a) (eCFR)The first annual wellness visit includes a written screening schedule, such as a checklist for the next 5 to 10 years, based on United States Preventive Services Task Force and Advisory Committee on Immunization Practices recommendations and the person's health risk assessment, health status and screening history.
Source: 42 CFR 410.15(a) (eCFR)The CY 2026 Physician Fee Schedule final rule identifies HCPCS code G0402 as the code for the Welcome to Medicare visit and G0438 and G0439 as the codes for the annual wellness visits.
Source: Federal Register, November 5, 2025 (CY 2026 Physician Fee Schedule final rule), on govinfo.govThe U.S. Preventive Services Task Force assigns each recommendation one of five letter grades: A, B, C, D or I.
Source: U.S. Preventive Services Task Force, Grade Definitions
Voice of success
We don't just build products; we forge lasting partnerships. See how we've helped industry leaders transform their vision into technical reality.
“I can clearly see how Agnotic has a unique way of handling end-to-end development. They are always active on quick chat and provide support quickly.”
Aaron Phelan
Founder, Benchmark
“Agnotic combines deep technical expertise with strong domain knowledge. They understand the business context, anticipate challenges, and make collaboration smooth and effective.”
John Pasmore
Founder, Latimer
“Agnotic is the best technical team we evaluated. Their engineering excellence made our work dramatically easier and allowed us to stay focused on what matters most for maternal care outcomes. They took full ownership of the technical execution, and we are always happy to continue working together.”
Kim Smith
Founder, My Lauren
Related services
Related primary care and prevention services
This page covers the AWV program. These pages cover the forms, outreach and care programs around it.
Patient questionnaire form and intake software
Building the health risk assessment and other forms, and writing answers back to the EHR.
Primary care software solutions
Software for the primary care practices that run AWV programs.
Population health management software
Registries, risk lists and outreach across a patient population.
Value-based care platform development
Quality, attribution and analytics for value-based contracts.
Care management software
Care plans and follow-up for patients the AWV flags for support.
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Frequently Asked Questions
The IPPE, or Welcome to Medicare visit, is available only in the first year of Part B coverage and includes a physical examination with a visual acuity screen. The AWV comes after that first year and centres on the health risk assessment and a personalized prevention plan.
It sends and tracks the assessment, checks that every required topic has an answer, and shows the answers to the clinician. The topics are in the health risk assessment table above; the form engine itself is covered on our patient questionnaire page.
Yes. 42 CFR 410.15 allows the assessment to be completed by the patient alone or administered by a health professional before or during the visit. The answers must still be the patient's own self-reported information, so the form records who entered each one.
No more than 20 minutes, under the 42 CFR 410.15 definition. We time the form with real patients during design, and move questions the clinician asks anyway, such as the cognitive check, out of the patient form.
It can hold a claim when the visit type does not match the patient's coverage history, when the lookback check fails or when a required element is open. Your billing team sets how each edit behaves and can release a held claim with a reason.
Yes. Most practices keep the AWV inside their EHR through a SMART on FHIR app or the EHR's own extension points, with the visit record, measurements and plan saved to the chart.
The EHR and how open its APIs are, the number of clinics, outreach channels, the billing edits you need and the reporting for value-based contracts. We explain these drivers on the scoping call rather than quote a price before it.
The visit holds history, screening answers and cognitive findings, so access is set by role, data is encrypted, and views and changes are logged. Agnotic builds with HIPAA-ready engineering and signs a business associate agreement before PHI is shared.
It depends on scope. We agree a fixed first release on the scoping call, usually eligibility checks, the due list and the element tracker for one clinic, and give you a timeline for it.
Industries