BREAKING NEWS: CMS Announces new CPT Codes for Advanced Care Planning

BREAKING NEWS:  CMS Announces new CPT Codes for Advanced Care Planning

CMS announced coverage under Part B for advanced care planning-CPT codes 99497 and 99498.


CPT Code 99497 – Advance care planning (ACP) 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

 CPT Code 99498 – Each additional 30 minutes (List separately in addition to code for primary procedure).  Also-for our RHC’s Beginning on January 1, 2016, ACP will be a stand- alone billable visit in a RHC or FQHC, when furnished by a RHC or FQHC practitioner and all other program requirements are met.


We encourage our members who operate provider based clinics to consider using this code.


Patrick Yount

Director of HIT


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