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CMS is considering whether clinical AI tools could help make Medicare Annual Wellness Visits more continuous and tailored to beneficiaries. The agency is seeking feedback on possible uses and barriers; it has not announced a change to who may provide the visits. Family physicians support some uses while warning that care should remain connected to a patient’s established primary care team.
The Centers for Medicare & Medicaid Services is asking whether clinical AI tools could make Medicare Annual Wellness Visits more continuous and tailored to beneficiaries, opening a policy discussion about how the visits are delivered. The agency’s proposal seeks feedback on possible uses and barriers; it does not announce a change to the current requirement that a physician or other qualified health professional perform the visit, or that a medical team work under a physician’s direct supervision.
In its proposed physician payment rule, CMS said research on the Annual Wellness Visit’s effects is mixed. The agency cited studies associating visits with greater use of preventive services, while noting that some research found they did not close preventive care gaps. Other studies found no substantive link to improved evidence-based screening, acute care use or spending, and raised the possibility of more downstream low-value services. Those findings are the stated reason CMS is asking whether AI could change how the visit supports prevention.
CMS described potential tools that could collect beneficiary-reported information before an appointment, flag people who may need additional assessment, and generate suggested follow-up steps for a clinician to review. The agency framed the possibility as moving beyond a single, point-in-time assessment toward a more continuous, data-driven and beneficiary-specific preventive care function. These are examples under consideration, not services CMS has approved or required.
CMS also asked whether current rules create barriers to models in which an AI company develops or operates clinical tools and affiliates with a Medicare-enrolled provider or supplier. Under current policy, the visit must be performed by a physician or other health professional, or a team of medical professionals directly supervised by a physician enrolled as a Medicare provider. CMS has not said that vendors could independently furnish the visit.
AI’s Role in Preventive Visits
The discussion could affect how beneficiaries’ preventive needs are identified and followed up, and how much administrative work falls to clinical teams. If tools help gather health information or flag preventive care gaps, clinicians may have more capacity to discuss individual needs and coordinate next steps. Those are potential benefits described by supporters, not demonstrated outcomes from a CMS policy change.
The debate also concerns continuity and accountability. A wellness visit can involve a patient’s medical history, chronic conditions, behavioral health and personal goals. If parts of that work are handled outside an established care relationship, the patient and clinicians may face disconnected records or uncertainty about who is responsible for follow-up. CMS’s questions could shape whether future technology-enabled models reinforce existing care teams or alter their role.
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Current Rules and Mixed Evidence
The Annual Wellness Visit is a Medicare preventive service. CMS’s proposal starts from the agency’s stated concern that participation and outcome evidence leave room to examine how the service works. At the Health Datapalooza conference in Washington, D.C., CMS deputy administrator and chief clinical AI officer Stephanie Carlton said, “Only about half the seniors use [the AWV], and we don’t have good evidence that it’s actually resulting in better outcomes.” Carlton called that an opportunity for AI. The source report does not provide a separate participation estimate or specify the studies behind the mixed evidence.
The American Academy of Family Physicians, whose members provide these visits, expressed qualified support. The academy said AI could help identify eligible patients, summarize health information, find preventive care gaps, support documentation and facilitate follow-up. It also said the visit should connect prevention to a patient’s wider health circumstances and goals, and that this depends on an ongoing relationship with a physician-led team. In its comment letter, the AAFP warned that separating preventive services from primary care could lead to fragmented records, duplicate services, inconsistent recommendations and unclear follow-up responsibility.
““Evidence regarding the impact of the AWV on outcomes is mixed.””
— CMS, in the proposed physician payment rule
Open Questions on AI Delivery
CMS has not specified which AI tools, if any, it would approve for these visits, how their performance would be evaluated, or whether any payment or supervision rules will change. The proposal asks about barriers to arrangements involving technology companies and Medicare-enrolled providers, but the source report does not describe a particular model CMS has endorsed.
It is also unclear whether AI-supported visits would improve screening, health outcomes or follow-up, or reduce administrative work in practice. The evidence CMS cited is mixed, and the report gives no new study results measuring the proposed tools. The AAFP’s support is conditional: it favors tools that assist care teams and raises concerns about vendors independently furnishing significant portions of preventive care.
Final Rule Expected Around November
CMS is expected to release the final physician payment regulation around Nov. 1, according to the source report. The agency’s response may clarify whether it will revise policy, retain current requirements or offer further direction on technology-company partnerships. Until that rule is released, the proposal remains a request for feedback rather than a finalized change to Medicare wellness visits.
For beneficiaries and clinicians, the practical questions are whether AI tools will be used, which tasks they may support, and how records, clinician review and follow-up will remain connected. The proposal and the AAFP’s comments point to the central issue for the next stage: whether technology can assist preventive care while keeping responsibility with a patient’s care team.
Key Questions
Has Medicare approved AI-run Annual Wellness Visits?
No. CMS is seeking feedback on possible AI uses and delivery models. The proposal does not approve AI-run visits or announce a policy change.
What could AI tools do during the process?
CMS named possible uses including collecting beneficiary-reported information before a visit, flagging people who may need further assessment, and suggesting follow-up steps for a clinician to review.
Who must provide an Annual Wellness Visit under current policy?
CMS says a physician or other health professional must perform it, or a team of medical professionals must work under a physician’s direct supervision. The physician must be enrolled as a Medicare provider.
What concerns has the AAFP raised?
The academy supports AI tools that assist care teams, but warns that services outside a patient’s established primary care relationship could fragment records, duplicate services and leave follow-up responsibility unclear.
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