Annual Wellness Visit Questions: How to Prepare for a Health Risk Assessment

A Medicare Annual Wellness Visit (AWV) centers on the Health Risk Assessment (HRA) — a structured, self-reported questionnaire covering your health status, daily function, and risk factors that shapes a personalized prevention plan. It is not a physical exam and does not diagnose or treat any current symptom.

What Does the Health Risk Assessment Cover?

The Centers for Medicare & Medicaid Services (CMS) sets minimum content requirements for the HRA. Because official program rules are more consistent than any one practice’s implementation, it helps to sort what you can expect by how certain it is.

Established: CMS Minimum HRA Elements

CMS requires the HRA to collect self-reported information in these areas, at minimum:

• Demographic data
• A self-assessment of your general health status
• Psychosocial risks — including depression, life satisfaction, stress, anger, loneliness or social isolation, pain, and fatigue
• Behavioral risks — including tobacco use, physical activity, nutrition and oral health, alcohol use, sexual health, motor vehicle safety (such as seat belt use), and home safety
• Activities of daily living (ADLs) — dressing, feeding, toileting, grooming, physical ambulation (including balance or fall risk), and bathing
• Instrumental activities of daily living (IADLs) — using the phone, food preparation, housekeeping, laundry, transportation, shopping, managing medications, and handling finances

You or your provider can complete or update the HRA before the visit or during it.

Established but Visit-Dependent: First vs. Subsequent AWV

The visit’s scope differs by whether this is your first AWV or a later one. At a first AWV, your provider also establishes your medical and family history, a current list of your providers and suppliers, baseline measurements (height, weight, BMI or waist circumference, blood pressure), a cognitive impairment check, a depression-risk review, a functional-ability and safety review, and a written screening schedule for the next five to ten years. A subsequent AWV updates those same categories rather than starting over, and measurements typically focus on weight and blood pressure rather than height.

Optional at Your Discretion

Two additional services can be offered as part of the AWV, but only if you choose them:

• Advance care planning — a conversation about future care preferences and documents such as a living will or health care proxy, with no limit on how many times you can revisit it during the year
• Physical activity and nutrition risk assessment — a brief, standardized screening tool your provider may use, covered once every six months

Because these are optional, whether your provider raises them — and how — can vary by practice.

What’s Known vs. Unknown Before You Go?

• Known: CMS fixes the categories of information the HRA must collect, and they don’t vary by provider.
• Known: The AWV is preventive and planning-focused — it is billed differently from, and is not a substitute for, a visit to evaluate a new or worsening symptom.
• Known: Advance care planning and the nutrition/activity assessment are optional add-ons, not required parts of every visit.
• Unknown until your visit: Which specific screening tools your provider uses for depression, cognition, or fall-risk screening — CMS allows a range of standardized options.
• Unknown until your visit: How your individual screening schedule and risk-factor list will be shaped, since these depend on your personal and family history, not a template.
• Unknown without asking: Whether a specific concern you raise will require a separate, additional evaluation-and-management service billed alongside the AWV.

What Should You Bring to an Annual Wellness Visit?

CMS guidance on preparing eligible patients points to a short list of materials worth gathering ahead of time, so more of the visit can focus on conversation rather than reconstructing your history on the spot.

1. Medical records you have access to, including immunization records
2. A detailed family health history — conditions among parents, siblings, and children, including anything hereditary
3. A full list of medications and supplements, including calcium and vitamins, with how often and how much of each you take
4. A current list of every provider and supplier involved in your care, including community-based services such as home-delivered meals or adult day care, and any behavioral health providers
5. A short written list of your own questions or concerns, so limited visit time goes where you need it
6. If you want to discuss advance care planning, a note of who you’d want to speak for you if you couldn’t communicate your own wishes

When Is an AWV Not the Right Visit?

If you’re dealing with a new or worsening symptom — chest pain, a fall, a medication reaction, or anything that concerns you now — that calls for a problem-focused visit or, for anything urgent, local emergency services, not an AWV.

If your only goal is preventive planning and an updated screening schedule, an AWV fits. If you also have an active concern you want evaluated, mention it when scheduling — a separately billed, medically necessary evaluation-and-management service can sometimes be added to the same appointment, but that isn’t automatic just because you raise it during the visit.

For general guidance on making the most of any doctor’s appointment — including note-taking, bringing a trusted companion, and asking for written instructions — Start Here outlines how this publication approaches visit preparation. How We Research explains how we review sources like CMS guidance before they inform an article.

Frequently Asked Questions

Does Medicare cover the Annual Wellness Visit every year?

You can have one first AWV, then one subsequent AWV every 12 months after that. CMS won’t pay for a repeat AWV within 12 months of the last one, and you can’t bill the AWV within 12 months of an Initial Preventive Physical Exam for the same patient.

Is the Annual Wellness Visit the same as a physical exam?

No. The AWV is a planning and prevention visit built around the HRA, medical history review, and a written screening schedule. It includes routine measurements like weight and blood pressure, but it is not a comprehensive physical exam and does not diagnose conditions.

Can telehealth be used for an Annual Wellness Visit?

Yes. CMS covers the AWV when delivered by telehealth, the same as an in-person visit.

Who is allowed to perform an Annual Wellness Visit?

A physician, a qualified non-physician practitioner (physician assistant, nurse practitioner, or certified clinical nurse specialist), or another medical professional such as a health educator or registered dietitian working under a supervising physician can perform the AWV.

Will advance care planning cost extra during an Annual Wellness Visit?

Not if it’s provided the same day by the same AWV provider and billed correctly — CMS waives the Part B deductible and coinsurance for advance care planning once per year when it’s billed alongside the AWV. Outside that pairing, standard deductible and coinsurance rules apply.

Educational Information Disclaimer

This article is educational information only and does not replace advice from your own doctor or health care provider. It does not diagnose, treat, or recommend any medical decision. Coverage details, billing rules, and screening recommendations can change; confirm current specifics with Medicare.gov or your provider’s office before your visit. Primary Care Visit Guide is an independent educational publication and is not a medical clinic, local provider, appointment service, or physician practice.

By Primary Care Visit Guide Editorial Team. Updated September 9, 2026.