CMS is asking a big question in its proposed physician payment rule: should AI play a bigger role in Medicare's annual wellness visit (AWV)? Right now, the AWV must be led by a physician or supervised health professional — but CMS wants to know if AI tools could help transform it from a single, point-in-time checkup into a more continuous, personalized preventive care experience.

The agency is eyeing AI applications for pre-visit health risk assessments, identifying patients who may need extra attention, and generating follow-up recommendations for clinicians to review. CMS's chief clinical AI officer, Stephanie Carlton, noted the opportunity plainly: only about half of eligible seniors use the AWV, and the evidence that it actually improves outcomes is mixed at best.

The American Academy of Family Physicians (AAFP) is cautiously supportive — but with guardrails. The group backs AI tools that reduce administrative burden and close care gaps, but warns against models that let tech vendors or AI companies deliver preventive care outside of an established primary care relationship.

Key Takeaways:

• Evidence on AWV effectiveness is mixed — some studies show increased preventive service use, others show no meaningful impact on outcomes or spending
• AAFP supports AI-assisted AWVs but opposes models that fragment care or displace physician accountability
• CMS's final payment rule is expected around November 1

Why it matters: If CMS greenlights AI-enhanced AWVs, it could reshape how preventive care is delivered to millions of Medicare beneficiaries — and the debate over how to integrate AI without undermining continuity of care is central to getting it right.