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11/02/2014

Medicare to Pay for Advance Care Planning

Hopefully, the third time really will be the charm.  Over the past few years, expanding Medicare coverage for advance care planning famously failed once through legislation and once through regulation.  But it might really now happen.


On Friday, the Centers for Medicare and Medicaid Services (CMS) issued a final rule (PDF here) for physician reimbursement under Medicare in 2015.  Notable are these two codes:

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 care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surrogate

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 care professional; each additional 30 minutes (list separately in addition to code for primary procedure)”

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