Does Medicare recommend a cognitive test? All you need to know about your Annual Wellness Visit

Oct 14, 2025 3 min read •

Medicare Senior Health Cognitive Health

According to the Centers for Medicare & Medicaid Services (CMS), the detection of cognitive impairment is a required element of your Annual Wellness Visit (AWV). This means that while there is no specific does medicare recommend a cognitive test mandate for a standalone test, your healthcare provider must evaluate your cognitive function as part of this yearly, preventive check-up.

Quick Summary

Detecting cognitive impairment is a required part of Medicare's Annual Wellness Visit. A provider can use direct observation or a brief test for screening. If concerns arise, a more detailed assessment is covered under Part B, leading to a care plan. This service helps with early detection of conditions like dementia and Alzheimer's disease.

Key Points

Cognitive Screening is Required: A check for cognitive impairment is a mandatory part of every Medicare Annual Wellness Visit (AWV), not a separate, optional test.
Methods Vary: Providers can use direct observation, family input, or brief screening tools like the Mini-Cog to fulfill the AWV's cognitive assessment requirement.
Free at AWV: The cognitive screening during your Annual Wellness Visit is a preventive service and is covered at no cost if your provider accepts assignment.
Further Assessment Covered: If the initial screening suggests a problem, Medicare Part B covers a separate, in-depth cognitive assessment and care plan service (CPT code 99483).
Early Detection is Crucial: Identifying cognitive issues early enables more effective symptom management and gives patients the opportunity to participate in their own care planning.

Your Medicare Annual Wellness Visit Includes a Cognitive Screening

It is a common misconception that a full-fledged cognitive test is automatically performed and billed at a Medicare Annual Wellness Visit (AWV). In reality, the requirement is for the healthcare provider to screen for signs of cognitive impairment. This can involve a variety of methods and doesn't always include a formal, written test.

How Your Provider Screens for Cognitive Issues

During your AWV, your doctor or health care provider will assess your cognitive function by doing the following:

Observing you directly: They will take note of your conversation, behavior, and appearance during the visit.
Considering concerns: They will listen to any concerns raised by you, your family, or other caregivers about changes in your memory, judgment, decision-making, or ability to manage daily tasks.
Using a brief screening tool: They may use a brief, standardized test like the Mini-Cog or a clock-drawing test to get a baseline measure of your cognitive function.

This initial screening is a required part of the AWV and comes at no cost to you, provided your doctor accepts assignment. It is a proactive step meant to catch early signs of cognitive decline rather than to provide a definitive diagnosis.

More Detailed Cognitive Assessment and Care Planning (CPT Code 99483)

If the initial screening at your AWV suggests a potential issue with your cognitive function, Medicare Part B covers a separate, more comprehensive visit for a full cognitive assessment and care plan. This service, billed under CPT code 99483, is a more in-depth evaluation designed to establish or confirm a diagnosis like dementia or Alzheimer's disease.

What to Expect During a Comprehensive Cognitive Assessment

This is a more involved appointment, often lasting around an hour and involving an independent historian (such as a family member or caregiver) who can provide additional context. It is a face-to-face service with a physician or other eligible healthcare provider that includes:

A comprehensive medical history and review of records.
A physical examination with a focus on observing cognition.
A functional assessment of your basic and instrumental activities of daily living (IADLs).
The use of standardized instruments for staging dementia, if applicable.
A safety evaluation related to home and motor vehicle operation.
An evaluation of neuropsychiatric and behavioral symptoms.
Addressing advance care planning.

Comparison of Medicare Cognitive Services

To clarify the difference between the cognitive screening at an AWV and the detailed assessment, consider this comparison:


Feature	Annual Wellness Visit (AWV) Screening	Detailed Cognitive Assessment (CPT 99483)
Purpose	To detect early signs of cognitive impairment.	To confirm a diagnosis (like dementia) and create a care plan.
Cost	No cost to beneficiary if provider accepts assignment.	Requires Part B deductible and 20% coinsurance.
Timing	Part of the annual preventive visit.	A separate, dedicated visit after impairment is suspected.
Duration	Brief, often just a few minutes.	Typically 50-60 minutes face-to-face.
Involved Parties	Patient and provider.	Patient, provider, and independent historian.
Billing	G0438 (initial AWV) or G0439 (subsequent AWV).	CPT code 99483.

The Importance of Early Detection and Care Planning

While the prospect of a cognitive evaluation can be intimidating, early detection of cognitive impairment is crucial. Early diagnosis of conditions like dementia allows you to:

Improve treatment outcomes: Early intervention can help manage symptoms and slow cognitive decline.
Empower you to make decisions: You can participate in care decisions and financial planning while you are still able to do so.
Plan for the future: This includes discussing advanced care planning and palliative care needs.
Identify reversible conditions: Sometimes, cognitive symptoms can be caused by treatable issues like depression, anxiety, or vitamin deficiencies.

If the assessment confirms a diagnosis, the resulting care plan is a valuable tool for addressing symptoms and functional limitations. The plan can also connect you with important community resources such as support groups, rehabilitation services, and adult day programs. For more information on assessing cognitive impairment, you can visit the National Institute on Aging's resources for professionals.

Conclusion: Proactive Care is Covered

To conclude, while Medicare does not mandate a formal cognitive test for everyone, it does recommend and require that healthcare providers screen for cognitive impairment as a standard part of the no-cost Annual Wellness Visit. For those with signs of cognitive decline, Medicare Part B offers comprehensive coverage for a more thorough assessment and the development of a care plan. Taking advantage of this preventive benefit is a vital step toward managing your health proactively and ensuring a better quality of life for yourself and your loved ones.

Frequently Asked Questions

While a cognitive assessment is a required element of the Medicare Annual Wellness Visit (AWV), a specific, formal test is not mandatory. Your healthcare provider can fulfill the requirement through direct observation or by considering concerns raised by you or your family.

If your doctor identifies signs of cognitive impairment during your AWV, they may recommend a separate, more detailed cognitive assessment covered by Medicare Part B. This in-depth evaluation helps confirm a diagnosis and leads to the development of a comprehensive care plan.

No, the cognitive screening performed as part of your yearly Annual Wellness Visit is a preventive service covered by Medicare Part B at no extra cost, as long as your provider accepts assignment.

A more detailed assessment (CPT code 99483) is a separate visit that typically involves a comprehensive history, a functional assessment of daily activities, a review of medications, a safety evaluation, and the development of a written care plan.

Yes, if the cognitive assessment suggests a diagnosis like Alzheimer's disease, Medicare may cover diagnostic non-laboratory tests like brain scans (such as CT, MRI, or PET) to assist in the diagnosis.

For a detailed cognitive assessment (CPT code 99483), Medicare requires the involvement of an "independent historian," such as a spouse, family member, or caregiver. Their input is crucial for providing a reliable patient history.

Yes, following a cognitive assessment and diagnosis, Medicare Part B helps cover services for managing and treating cognitive impairment, including follow-up doctor visits, management of medications, and coordination of care.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.