Can my dermatologist code wellness for a visit? I have an annual check up each year with the dermatologist. If he finds an unusual mole, he removes and checks it. My insurance company says they will pay for this each year with no cost to me if it is coded wellness. The doctors office says the law changed a couple years ago due to the Affordable Care Act and they can no longer code wellness. I can’t find any such law. Everything I find is requiring insurance companies to pay wellness 100%. Are dermatologists an exception?
Everyone gets one free wellness visit a year. This is a chance to set up screenings that are also covered at no out-of-pocket costs. We don't see anything specifically saying your primary care provider has to administer the wellness visit, and your dermatologist can't. However, it may be as simple as the fact that a true wellness visit focuses on all aspects of health. The dermatologist visit and related services may still be covered as preventive screenings, but perhaps not as your wellness visit. We will do more research, in the meantime feel free to comment findings below.
Learn more about preventive services under the Affordable Care Act.