Yes. Medicare Part B covers a functional assessment as a required part of a separate cognitive visit to evaluate dementia, including Alzheimer's disease. A functional assessment means a clinician checks Basic and Instrumental Activities of Daily Living, including decision-making capacity. It helps show how memory or thinking changes affect daily life and care needs.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Official resources:
- Read the official guidance from Medicare — Use this primary source to verify the official guidance.
- Check eligibility on Medicare’s official study page — Use this page to check the study’s participation requirements.
Table of Contents
- What happens at the yearly Wellness visit?
- When do you get a full Alzheimer's evaluation?
- What does the functional assessment include?
- What does it cost and how should you prepare?
What happens at the yearly Wellness visit?
Medicare Part B covers a yearly Wellness visit. It must include a cognitive check for dementia, including Alzheimer's disease. That check looks for trouble with remembering, learning, concentrating, managing finances, and making everyday decisions.
According to Medicare.gov, the Wellness visit is described in its Yearly Wellness Visits page. The Wellness visit is a conversation-based prevention plan, not a routine physical. Bring a list of medicines, doctors, and daily problems to make the talk useful.
When do you get a full Alzheimer's evaluation?
If the Wellness screening suggests impairment, Medicare Part B covers a separate, more thorough visit. It reviews cognitive function and can establish or confirm dementia or Alzheimer's disease. That visit also checks for depression, anxiety, or delirium.
It ends with a written care plan. The visit is billed as CPT 99483 for assessment and care planning for cognitive impairment at any stage. It replaced HCPCS G0505 in 2018.
What does the functional assessment include?
The Centers for Medicare and Medicaid Services requires specific documentation for CPT 99483. According to the agency, the rules are detailed in its Billing and Coding Article for cognitive assessment. The clinician must record Basic and Instrumental Activities of Daily Living, including decision-making capacity.
Basic activities include bathing, dressing, and eating. Instrumental activities include cooking, shopping, taking medicine, and handling money. The visit must also include standardized dementia staging, such as FAST or Clinical Dementia Rating, plus medicine review, safety and caregiver assessment, and written care and advance-care plans.
What does it cost and how should you prepare?
The yearly Wellness visit costs $0 when the provider accepts assignment, and the Part B deductible does not apply. The separate cognitive assessment generally costs 20% of the Medicare-approved amount after the Part B deductible.
Actual cost varies with other insurance, assignment, and setting. According to Medicare.gov, cost details appear on its cognitive assessment and care plan page.
- Bring a spouse, friend, or caregiver to help answer questions.
- Ask beforehand what is preventive versus diagnostic and what you will owe.
- Ask if added tests during the same visit will trigger deductible or coinsurance.
- If your provider participates, ask about added support through the GUIDE Model pilot for dementia and unpaid caregivers.
