Annual Physical vs. Comprehensive Medical Exam
A new patient appointment is always considered a Comprehensive Medical Exam. This is because it includes a complete review of your health, a physical exam, and a discussion of chronic or new concerns.
Annual Physical (Preventive Visit) / Annual Wellness
- Focuses on prevention only
- Includes review of overall health, screening for future risks, updating vaccines, and recommending preventive tests
- Does not address or treat chronic medical problems
Billed as a preventive visit (often fully covered by insurance)
Comprehensive Medical Exam & Management
- Includes most aspects of a physical exam plus diagnosis and treatment planning for chronic diseases or new symptoms/conditions
- May include:
- Review of symptoms and medical history
- Detailed physical exam
- Ordering and/or interpreting lab or imaging tests
- Adjusting or prescribing medications
- Referrals to specialists
- Personalized follow-up plan
- Billed as an office visit (E/M code), sometimes in addition to a preventive exam if both are performed at the same visit
E/M codes are usually subject to deductibles, copays, and coinsurance under most insurance plans
Why this matters for billing
If your visit covers both preventive services and medical management, insurance rules require us to bill for both services or for the comprehensive service only. We cannot bill for an annual physical alone when a full evaluation and treatment are also provided. This ensures accurate documentation and compliance with insurance guidelines.