# HCPCS G0438: Annual wellness visit, initial visit (Medicare)

Medicare HCPCS G0438 pays $174.35 in a non-facility setting and $174.35 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $160.06 in Arkansas to $220.54 in Alaska, a 38% spread.

Web page: https://www.med-reveal.com/rates/G0438-hcpcs-fee-schedule
Section: Evaluation and Management

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $174.35 |
| National facility | $174.35 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $220.54 | $220.54 |
| District of Columbia | $194.25 | $194.25 |
| New York | $189.97 | $189.97 |
| California | $189.86 | $189.86 |
| New Jersey | $189.61 | $189.61 |
| Washington | $187.35 | $187.35 |
| Massachusetts | $186.05 | $186.05 |
| Connecticut | $183.58 | $183.58 |
| Hawaii | $183.17 | $183.17 |
| Florida | $180.00 | $180.00 |
| Maryland | $179.40 | $179.40 |
| Colorado | $179.39 | $179.39 |
| Rhode Island | $178.09 | $178.09 |
| Oregon | $177.86 | $177.86 |
| Illinois | $177.07 | $177.07 |
| New Hampshire | $177.00 | $177.00 |
| Puerto Rico | $175.17 | $175.17 |
| Virgin Islands | $175.17 | $175.17 |
| Montana | $174.34 | $174.34 |
| Pennsylvania | $173.85 | $173.85 |
| Nevada | $173.49 | $173.49 |
| Delaware | $173.23 | $173.23 |
| Texas | $173.16 | $173.16 |
| Wyoming | $172.88 | $172.88 |
| Minnesota | $172.73 | $172.73 |
| Georgia | $171.84 | $171.84 |
| Michigan | $171.68 | $171.68 |
| Virginia | $171.29 | $171.29 |
| Arizona | $171.00 | $171.00 |
| North Dakota | $170.98 | $170.98 |
| Vermont | $170.73 | $170.73 |
| South Dakota | $170.58 | $170.58 |
| Utah | $168.86 | $168.86 |
| New Mexico | $168.70 | $168.70 |
| Maine | $168.59 | $168.59 |
| Missouri | $167.53 | $167.53 |
| Louisiana | $167.50 | $167.50 |
| Ohio | $167.28 | $167.28 |
| South Carolina | $167.28 | $167.28 |
| Wisconsin | $166.99 | $166.99 |
| North Carolina | $166.82 | $166.82 |
| West Virginia | $166.08 | $166.08 |
| Indiana | $165.46 | $165.46 |
| Idaho | $164.81 | $164.81 |
| Kentucky | $164.79 | $164.79 |
| Nebraska | $164.52 | $164.52 |
| Oklahoma | $164.33 | $164.33 |
| Tennessee | $164.28 | $164.28 |
| Iowa | $163.97 | $163.97 |
| Kansas | $163.68 | $163.68 |
| Alabama | $161.66 | $161.66 |
| Mississippi | $161.50 | $161.50 |
| Arkansas | $160.06 | $160.06 |

## Related codes

- 99381: Initial preventive medicine visit, new patient, infant (under 1 year) — https://www.med-reveal.com/rates/99381-cpt-fee-schedule
- 99382: Initial preventive medicine visit, new patient, early childhood (1-4 years) — https://www.med-reveal.com/rates/99382-cpt-fee-schedule
- 99383: Initial preventive medicine visit, new patient, late childhood (5-11 years) — https://www.med-reveal.com/rates/99383-cpt-fee-schedule
- 99384: Initial preventive medicine visit, new patient, adolescent (12-17 years) — https://www.med-reveal.com/rates/99384-cpt-fee-schedule
- 99385: Initial preventive medicine visit, new patient, 18-39 years — https://www.med-reveal.com/rates/99385-cpt-fee-schedule
- 99386: Initial preventive medicine visit, new patient, 40-64 years — https://www.med-reveal.com/rates/99386-cpt-fee-schedule
- 99387: Initial preventive medicine visit, new patient, 65 years and older — https://www.med-reveal.com/rates/99387-cpt-fee-schedule
- 99391: Periodic preventive medicine visit, established patient, infant (under 1 year) — https://www.med-reveal.com/rates/99391-cpt-fee-schedule

Commercial negotiated rates for G0438 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules