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See a sample rate comparisonHCPCS G0438 Fee Schedule
Medicare rates as of October 2026
HCPCS G0438 is classified under Procedures / Professional Services, in the Counseling, Screening, and Prevention Services subgroup.
Annual wellness visit; includes a personalized prevention plan of service (PPPS), initial visit
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Counseling, Screening, and Prevention Services |
| Add-on Codes | G0506G0513 |
| Common Revenue Codes | 05210510Sign up to view all 6 |
| Medicare Fee Schedule | $174.35 national non-facility rate (2026)View Medicare rates for G0438 |
| Medicaid Fee Schedule | $140.14 median of the 8 states in the free previewView Medicaid rates for G0438 |
National average reimbursement for HCPCS G0438 by major payers:
$211.42
BCBS / Anthem
$211.14
UnitedHealthcare
$186.77
Aetna
$178.10
Cigna
Compare published rates across providers.
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HCPCS G0438
5 of 25 sample ratesHigher to lower in this preview
Nana Safoaah
$304.17Published rateKathy Kerr
$304.17Published rateVanessa Trespalacios
$293.54Published rateSamina Syed-Naqvi
$273.76Published rateRachel Shur
$273.76Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0438 vs. Other Counseling, Screening, and Prevention Services Codes
The table lists codes related to G0438. Select one to see its fee schedule.
| Code | Description |
|---|---|
| G0435-HCPCS | Infectious agent antibody detection by rapid antibody test, HIV-1 and/or HIV-2, screening |
| G0438-HCPCS | Annual wellness visit; includes a personalized prevention plan of service (PPPS), initial visit |
| G0439-HCPCS | Annual wellness visit, includes a personalized prevention plan of service (PPPS), subsequent visit |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0438. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0438 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
Which add-on codes are billed with HCPCS G0438?
CMS add-on code edits list HCPCS G0438 as a primary code for these add-on codes: G0506 and G0513.
Which revenue codes are billed with HCPCS G0438?
Hospital price transparency files list HCPCS G0438 under these revenue codes: including 0521, 0510, 0983, 0770 and 0960. A revenue code names the hospital department or charge category for the line; it does not change what the service is.