CMS Announced Upcoming Activation of Advance Care Planning Codes

Posted on Tuesday, November 17, 2015 12:06 PM

The Centers for Medicare & Medicaid Services (CMS) made public on November 16th, the final rule which governs Medicare Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2016.  This major final rule  addresses changes to the physician fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute.  As part of this final rule, CMS announced its plans to move forward with 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)].

  For more information, click here.


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