How should MAOs report annual wellness visits to CMS?


To the extent that the MAO provides more than one annual wellness visit per year to a beneficiary, the MAO may submit the data to the RAPS and encounter data systems.  For risk score calculation all diagnoses that meet risk adjustment criteria are considered.  For information on the filtering rules applicable to encounter data, please see the December 22, 2015 HPMS memo with subject line “Final Encounter Data Diagnosis Filtering Logic”.

Source: MAO Help Desk Inquiry answered in November 2019

Last Updated: 11/01/2019