How much can a typical practice capture in AWV revenue?

An independent primary care practice with 500 Medicare patients typically has 100 to 150 AWV-eligible patients sitting on the panel at any given time. Without automation, capture rates hover around 30 to 40 percent. With automated outreach, those rates typically climb to 60 to 80 percent. For a single-provider practice, that gap represents approximately 140 additional AWVs per year at an average reimbursement of $138 — roughly $19,000 annually.

AWV Automation

How to capture more Annual Wellness Visits without adding staff.

Q: What does an Annual Wellness Visit pay?

Medicare's 2026 national average reimbursement is approximately $174 for the Initial AWV (G0438) and $138 for the Subsequent AWV (G0439). Add-on codes like G2211 (longitudinal care complexity) and ACP (Advance Care Planning) can increase reimbursement further. Actual rates vary by geography — the Physician Fee Schedule is the authoritative source for your specific area.

Q: Do patients actually respond to AWV outreach texts?

Yes, but response rates depend on three things: how the message is worded, whether it's practice-branded, and how easy the booking flow is. Alema's outreach is short, identifies the practice immediately, and includes a one-tap link to a secure booking page. Patients book directly without needing to call or log in to a portal.

Independent primary care practices typically capture only 30 to 40 percent of eligible Annual Wellness Visits — not because patients say no, but because nobody has time to identify, contact, and rebook every Medicare patient who qualifies. Alema does that work automatically. Identifies every eligible patient, sends the SMS, books the visit, writes back to your EHR, and proves the revenue.

See how Alema closes your AWV gap

The Problem

Eligible patients sit on your panel indefinitely.

A typical 500-patient Medicare panel has 100 to 150 patients eligible for an Annual Wellness Visit at any given time. The Initial AWV (G0438) reimburses around $174 nationally. The Subsequent AWV (G0439) reimburses around $138. Practices know these visits exist and they want to bill them. The bottleneck is human attention.

Without a system, AWV identification looks like this: someone pulls a Medicare list out of the EHR, sorts by last visit date, identifies who's overdue, then a front desk staffer calls each one. Three voicemails later, the project stalls. The eligible patients stay eligible. Twelve months pass. The window resets.

Practices that systematize AWV outreach — meaning consistent, multi-touch, low-friction follow-up — historically push capture rates from 35 percent up to 70 or 80 percent. That gap is real money. For a single-provider practice, it's roughly $19,000 per year. For a two-provider practice, closer to $38,000.

How It Works

How to capture more Annual Wellness Visits

01 / IDENTIFY

Every eligible patient, every day.

Alema scans your Medicare panel against AWV eligibility rules: 12+ months since last G0438 or G0439, no overlapping IPPE in the past 12 months. Every eligible patient is surfaced with months-overdue, payer, projected reimbursement, and a confidence score that flags missing data before outreach goes out.

02 / OUTREACH

Practice-branded SMS, no PHI.

A short HIPAA-safe text goes to the patient from a number tied to your practice. The message identifies you, explains there's a covered preventive visit available, and provides a one-tap booking link. No diagnosis, no procedure name, no PHI in the message body — full compliance with the HIPAA minimum-necessary standard.

03 / BOOK

Secure booking page, zero friction.

The patient taps the link, lands on a practice-branded booking page, sees the full context, picks a time that works, and completes a short pre-visit intake. The appointment writes back to your EHR's schedule automatically. No app to download, no portal login, no phone call needed.

04 / CAPTURE

Revenue attributed automatically.

When the visit is completed and the G0438 or G0439 CPT code lands in your EHR, Alema attributes the revenue to the originating outreach. Your Realized Revenue dashboard shows exactly which AWVs were Alema-sourced, how much they paid, and what the capture rate is by provider and by month.

The Math

What AWV capture looks like, by the numbers.

A typical single-provider primary care practice with 500 Medicare patients. National average reimbursement rates from the 2026 Medicare Physician Fee Schedule.

Eligible Patients

100-150

Medicare patients sitting on your panel right now, due or overdue for an AWV.

Capture Lift

2-3x

Practices that systematize outreach typically move from 30-40% capture to 60-80%.

Annual Revenue

~$19K

Additional AWV revenue per year for a single-provider practice. Scales linearly with provider count.

Common Questions

AWV automation, answered.

How does Alema decide which patients are eligible for an AWV?

Alema reads your EHR data via FHIR API and applies Medicare's eligibility rules: the patient must have Medicare Part B coverage, must be more than 12 months past their last AWV (G0438 or G0439), and must be 12 months past their Initial Preventive Physical (G0402) if they had one. Every eligible patient is flagged with a months-overdue value, a confidence score based on data completeness, and a projected reimbursement amount.

What does an Annual Wellness Visit pay?

The 2026 Medicare national average reimbursement is approximately $174 for the Initial AWV (G0438) and $138 for the Subsequent AWV (G0439). Add-on codes like G2211 (longitudinal care complexity, +$16-25) and ACP (Advance Care Planning, +$78) can layer additional reimbursement on top. Actual rates vary by geographic locality — the Medicare Physician Fee Schedule is the authoritative source for your specific area.

How much AWV revenue can a typical practice capture?

For an independent primary care practice with 500 Medicare patients, the eligible-patient pool is typically 100 to 150 patients at any given time. Without automation, capture rates hover around 30 to 40 percent. With consistent automated outreach, those rates typically climb to 60 to 80 percent. For a single-provider practice, the gap represents roughly 140 additional AWVs per year at an average reimbursement of $138 — approximately $19,000 in annual revenue.

Do patients actually respond to AWV outreach texts?

Response rates depend on three things: how the message is worded, whether it's clearly practice-branded, and how easy the booking flow is. Alema's outreach is short, identifies the practice immediately, and includes a one-tap link to a secure booking page. Patients book directly without needing to call the office or log in to a portal. Practices using this approach typically see 40-60 percent of contacted patients engage with the link, and 30-50 percent of those who click ultimately book.

What if a patient doesn't respond?

Alema runs a multi-step cadence — typically two automated nudges spaced a week apart. If the patient hasn't booked after the final nudge, they move to a No Response state on your dashboard where your staff can call them directly, log the call result, or mark them as not interested. Alema doesn't send a third automated text because past that point, additional messages feel like spam and reduce future engagement.

Other Revenue Engines

AWV is one of four. See the rest.

Get Started

See your AWV gap. Then close it.

Book a 15-minute walkthrough. We'll connect to your EHR (read-only), show you exactly which patients are eligible, and walk through what 90 days of automated outreach would look like for your practice.

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Industry statistics referenced on this site are drawn from publicly available research, government data, and primary care industry benchmarks. Examples of revenue figures, savings, and timelines shown are illustrative and not based on Alema customer data. Individual practice results will vary based on practice size, payer mix, patient demographics, provider availability, and other factors. Alema Health is a decision-support platform; nothing on this site constitutes medical, legal, billing, or coding advice. Alema Health does not guarantee specific revenue, financial, or clinical outcomes.