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Provider Add-On Payment Program

To help re-engage members in the wake of COVID-19, iCare announces a new add-on payment program reimbursing providers for each qualifying Medicare Annual Wellness Visit.
Deadline Extended to December 31, 2020! You now have more time to earn up to $200 in add-on payments for each qualifying AWV!



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Independent Care Health Plan (“iCare”) is pleased to announce an add-on payment program available to providers who perform qualifying Medicare Annual Wellness Visits for iCare members enrolled in an iCare Dual Eligible Special Needs Medicare Advantage Plan.  More information about the Medicare Annual Wellness Visit can be found here.  In addition to the Medicare fee for service rate, iCare will provide an additional $100.00 for each qualifying Medicare Annual Wellness Visit – including virtual visits! – billed under HCPCS codes G0438 or G0439 and completed between July 1, 2020 and September 30, 2020 December 31, 2020. 

To enroll or ask questions, Click Here. 

Each iCare Special Needs Medicare Advantage Plan enrollee is eligible for one Medicare Annual Wellness Visit per calendar year. Accepted billing codes that qualify for the add-on payment are G0438 or G0439.  iCare will also pay an additional $100.00 for services billed with this code if the provider submits medical records directly to iCare documenting the following components completed at the Medicare Annual Wellness Visit:   

  • Patient name and date of birth 

  • Date of service  

  • MD signature  

  • Medication Review 

  • Must be conducted by a MD, NP, PA, or clinical pharmacist and include the signature of practitioner who conducted the medication review 

  • A list of the patient’s medications in the medical record 

  • A review of all of the patient’s medications including prescription medications, OTC medications, and herbal or supplemental therapies 

  • Functional Status 

  • A standardized functional assessment conducted on the patient (Complete assessment of activities of daily living (“ADLs”) and/or instrumental activities of daily living (“IADLs”)) 

  • Pain Assessment 

  • A pain assessment conducted on the patient 

  • Advanced Care Planning 

  • A discussion or documentation about patient’s preferences for resuscitation, life-sustaining treatment, power of attorney for health care, and end of life care  

  • Blood pressure reading 

  • BMI  

  • A1c results (if applicable) 

Documentation must be sent via fax or e-mail to iCare as follows within thirty (30) days of the date of the Medicare Annual Wellness Visit:  

Independent Care Health Plan 

Attn: Quality Improvement Department 

Annual Wellness Visit Documentation 

Fax: 414-918-7592 


Payments of the secondary $100.00 related to medical records will be issued quarterly. 

A contract addendum will be sent to iCare network providers who have historically submitted claims for Medicare Annual Wellness Visits.  Please watch for follow up communication and the addendum, and if you wish to participate in the add-on payment program, sign and return it to iCare promptly. Non-contracted providers can contact the iCare Network Development Department at to receive a Participation Agreement for the program, which they must sign and return. 


 To enroll or ask questions, Click Here. 




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