CMS Issues Advance Care Planning Fact Sheet
September 23, 2016 02:26 PM
On October 30, 2015, the Centers for Medicare & Medicaid Services (CMS) made public a final rule governing Medicare Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY2016, which includes information on payment for advance care planning (ACP) services. As part of the final rule, CMS announced activation of:
CPT code 99497[Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed) by the physician or other qualified health professional; first 30 minutes, face-to-face with the patient, family member(s) and/or surrogate] ; and
An add-on CPT code 99498, [Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health professional; each additional 30 minutes (List separately in addition to code for primary procedure)].
ACP services may be provided by a hospice physician or hospice-employed nurse practitioner (NP) designated to serve as the hospice patient’s attending physician.
Most recently, CMS issued additional information related to ACP in the form of an Advance Care Planning Fact Sheet, which contains:
Information on how to code ACP services
Provider and beneficiary eligibility information
How to bill ACP services
An example of ACP in practice
CMS has also issued a Frequently Asked Questions (FAQs) document that was updated in July 2016; it is available here.
Previous NAHC Report coverage on the rule is available here, here, and here.