Advanced Care Planning Gets Paid Separately When billed with Wellness Visit.
A face-to-face service between a physician (or other qualified health care professional) and the patient and/or his family or surrogate, to discuss advance directives, with or without completing relevant legal forms is Voluntary Advanced Care Planning (ACP). The Centers for Medicare and Medicaid Services (CMS) describes an advance directive as, ?a document appointing an agent and/or recording the wishes of a patient pertaining to his/her medical treatment at a future time should he/she lack decisional capacity at that time.?
CMS will pay for 99497Advance 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) separately with an annual wellness visit (AWV) from January 1st 2016.
?When voluntary Advanced Care Planning services are furnished as a part of an Annual Wellness Visit, the coinsurance and deductible would not be applied for Advanced Care Planning, as per the CMS Guidelines.Under that circumstance, both the Advanced Care Planning and Annual Wellness Visit must also be billed together on the same claim, to have the deductible and coinsurance waived for Advanced Care Planning when performed with an Annual Wellness Visit, the Advanced Care Planning code(s) must be billed with modifier 33 (Preventive services). Since payment for an Annual Wellness Visit is limited to only once a year, the deductible and coinsurance for Advanced Care Planning billed with an Annual Wellness Visit can only be waived once a year.?