G0438 HCPCS Level II Code: Annual wellness visit; includes a personalized prevention plan of service (PPS), initial visit
Medicare Coverage & Payment
- CMS short descriptor: Ppps, initial visit
- Medicare coverage: Carrier judgment (CMS coverage code C)
- Pricing indicator: 11
- BETOS: M5D — Specialist - other
- Last CMS action effective: January 1, 2026
Source: CMS HCPCS Level II release. Coverage codes indicate how Medicare treats the code, not whether a specific claim will be paid; payer policy and documentation still govern.
Contextual Map
Every relationship of G0438 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Nearest codes (40)
- G0417 — Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 21-40 specimens[Sibling]— CMS HCPCS Level II code set
- G0418 — Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 41-60 specimens[Sibling]— CMS HCPCS Level II code set
- G0419 — Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, >60 specimens[Sibling]— CMS HCPCS Level II code set
- G0420 — Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour[Sibling]— CMS HCPCS Level II code set
- G0421 — Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour[Sibling]— CMS HCPCS Level II code set
- G0422 — Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session[Sibling]— CMS HCPCS Level II code set
- G0423 — Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session[Sibling]— CMS HCPCS Level II code set
- G0424 — Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day[Sibling]— CMS HCPCS Level II code set
- and 32 more
Change history
- January 1, 2011 — Added to the code set [Change history]— CMS release files (code change ledger)
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, descriptors, coverage and pricing attributes Official source data
- CMS HCPCS Alpha-Numeric (ANWEB) release — July 2026 quarterly update Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS HCPCS quarterly update files, ingested into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Change history
- January 1, 2011Added to the code setAnnual wellness visit; includes a personalized prevention plan of service (pps), initial visit
Nearest Codes in This Family
Official HCPCS Level II classifications closest to G0438 in its code family, with their registry titles.
- G0433 — Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening
- G0434 — Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter
- G0435 — Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening
- G0436 — Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes
- G0437 — Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes
- G0439 — Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
- G0442 — Annual alcohol misuse screening, 5 to 15 minutes
- G0443 — Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes
- G0444 — Annual depression screening, 5 to 15 minutes
- G0445 — High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed…