NAHC Urges HHS to Make Separate Payment for Advanced Care Planning Codes
June 24, 2015 04:05 PM
The National Association for Home Care & Hospice (NAHC) recently joined over 60 organizations—including AARP and the American Medical Association (AMA)—in supporting separate payment for advance care planning codes (ACP). In a letter addressed to Secretary of Health and Human Services Sylvia Burwell, NAHC and the other organizations urged the Administration to start making separate payment for these ACP codes in CY 2016.
AMA through the Current Procedural Terminology (CPT) Editorial Panel developed two new codes—99497 and 99498—for complex ACP. NAHC endorsed the thorough process undertaken by the AMA to craft the codes to ensure they address the needs of both caregivers and patients.
Complex ACP is defined to include at least one voluntary 30-minute meeting designed to discuss and document the patient’s preferences for their treatment plan, thereby helping the patient make decisions for their future care. The patient has the option of including his or her family or caregiver in the process.
“Published, peer‐reviewed research shows that ACP leads to better care, higher patient and family satisfaction, fewer unwanted hospitalizations, and lower rates of caregiver distress, depression and lost productivity,” NAHC and the other organizations wrote in the letter. “ACP is particularly important for Medicare beneficiaries because many have multiple chronic illnesses, receive care at home from family and other caregivers, and their children and other family members are often involved in making medical decisions.”
In the letter, NAHC and the other organizations further argue that making separate payment for ACP would promote ACP services. In addition, payment for ACP would allow Medicare to better track these services as well as the extent to which the services improve quality of life and effectiveness of care. Payment for ACP would align with existing quality reporting programs, such as the physician quality reporting system, that promote higher quality and value in the system.
The Institute of Medicine, in its 2014 report “Dying in America,” included ACP payment as one of its top five recommendations, stating: “payers and health care delivery organizations should adopt these standards and their supporting processes, and integrate them into assessments, care plans and the reporting of health care quality.”
CMS is expected to release its CY 2016 physician payment rule in the coming weeks. NAHC Report will continue to provide updates regarding this issue.