Get Paid for End-of-Life Care Discussions With Patients
By David Doolittle


Have you talked to your patients about voluntary advance care planning? 

Did you know that Medicare will pay for those discussions as either a separate Part B medically necessary service or an optional element of a patient’s annual wellness visit? 

It’s true. 

Since 2016, the Centers for Medicare & Medicaid Services (CMS) has used two Current Procedural Terminology (CPT) payment codes for conversations about end-of-life treatment. 

But don’t worry if you didn’t already know that. Most physicians who are likely to talk to their patients about advance care still don’t use the codes, a study published in JAMA International Medicine shows. 

Despite 61% of Texas physicians reporting that they talk to their patients about end-of-life care, only 16% bill Medicare for such discussions, according to the Texas Medical Association’s 2018 physician survey

CMS describes voluntary advance care planning as “a face-to-face service between a physician (or other qualified health care professional) and a patient discussing advance directives with or without completing relevant legal forms.” An advance directive is a document in which the patient appoints an agent and/or records the type of care they want to receive if they cannot decide for themselves at the time. 

There are no limits to the number of times you can report advance care planning discussions for a given patient over a given time, CMS said. There are also no place-of-service limitations, no diagnosis is needed, and any specialty can use the codes for such conversations. 

“Some people may need (advance care planning) multiple times in a year if they are quite ill and/or their circumstances change,” CMS said. “Others may not need the service at all in a year.” 

More information, including a description of the codes, can be found on CMS’ website

TMA also has several CME courses related to advance care planning and end-of-life care:

As part of your TMA membership, these and hundreds of other CME and ethics hours are now available at no cost to you, compliments of TMA Insurance Trust.

Last Updated On

July 18, 2019

Originally Published On

July 18, 2019