For Federally Qualified Health Centers (FQHCs), the Annual Wellness Visit (AWV) isn’t just another preventive service—it’s a powerful catalyst for improving patient care, driving revenue growth, and strengthening readiness for value-based care models.

Here’s why AWVs deserve a top spot in your FQHC’s strategy, and how you can harness their full potential.

Why AWVs Matter

AWVs offer Medicare patients a comprehensive annual check-up focused on prevention, chronic disease management, and health goal-setting. For FQHCs, they provide a structured opportunity to:

Identify Care Gaps – AWVs include health risk assessments, screenings, and a personalized prevention plan, enabling early identification of chronic conditions and social needs.

Engage High-Risk Patients – The AWV visit opens the door to enrolling eligible patients in Chronic Care Management (CCM), Behavioral Health Integration (BHI), or Remote Patient Monitoring (RPM) programs.

Enhance Revenue Streams – AWVs are reimbursed at rates of approximately $175 per visit, and coupling them with CCM or RPM can significantly increase per-patient revenue.

Align with Value-Based Care – AWVs improve quality metrics, patient engagement, and documentation—key pillars for success in value-based contracts with Medicaid, Medicare Advantage, and commercial payers.

The Potential Impact for FQHCs

FQHCs serving 1,000 Medicare patients annually could see a transformative financial and clinical impact:

Annual Revenue Impact per 1000 Patients (Example):

Sources of Numbers in the Model

AWV Reimbursement Rate ($175)

• This is based on the Medicare reimbursement for an Annual Wellness Visit (HCPCS G0438 for the initial AWV and G0439 for subsequent AWVs). Rates can range from $150 to $200+ depending on geographic location and specific payer contracts.

CCM Enrollment Rate (30%)

• A conservative estimate based on industry benchmarks suggests that 20-40% of eligible Medicare patients seen for an AWV may qualify for and enroll in Chronic Care Management (CCM), especially when proactive outreach is used.

CCM Monthly Reimbursement ($62)

• This represents the national average for CPT 99490 (CCM), which pays around $62 per month per patient. Higher complexity codes (e.g., CPT 99487) can bring in higher payments.

RPM Enrollment Rate (10%)

• This assumes that 10% of AWV patients may qualify for and enroll in Remote Patient Monitoring (RPM). This aligns with adoption rates at many FQHCs, though this number can increase with proactive recruitment.

RPM Monthly Reimbursement ($60)

• Based on Medicare’s reimbursement for RPM codes (CPT 99453, 99454, 99457). Average monthly reimbursement is around $60 per patient when billing for both device supply and monitoring time.

Clinical Outcomes:

• Improved chronic disease management

• Reduced emergency department visits and hospitalizations

• Enhanced patient satisfaction and trust

Strategic Benefits:

• Stronger positioning in value-based care programs

• Proactive management of high-risk populations

• Enhanced readiness for payer negotiations and reporting

Actionable Steps FQHC Executives Can Take

Here’s how your leadership can turn AWVs into a strategic advantage:

Prioritize AWV Implementation – Establish AWVs as a core component of your care delivery strategy. Allocate staff and resources to support consistent scheduling and outreach.

Build Proactive Outreach Campaigns – Use your EHR to identify eligible patients and conduct personalized outreach to schedule AWVs. Leverage trusted messengers like care managers or community health workers.

Streamline Pre-Visit Preparation – Gather updated medical histories, medication lists, and social needs assessments before visits to maximize the AWV’s value.

Integrate Care Management Enrollment – Use the AWV as a launching point for CCM, RPM, or BHI enrollment—train providers to identify eligible patients and discuss these services during the visit.

Monitor, Measure, and Optimize—Track AWV completion rates, enrollment in care management programs, and patient outcomes. Use the data to refine workflows, staff training, and patient engagement strategies.

Final Thought

For FQHCs, the Annual Wellness Visit isn’t just a checkmark on a to-do list; it’s a strategic lever for improving patient health, increasing revenue, and demonstrating leadership in value-based care. By investing in AWVs and pairing them with proactive care management, your health center can unlock new opportunities for growth, impact, and mission.

Annual Wellness Visits are just one way we help health centers drive quality. Schedule a one-on-one strategy session to learn more.

Enhance care between provider visits. Schedule a strategy session and care management impact assessment.