decisionhealth Newsletters, Answer Books - 2016 Issue 1 (January)
Advance care planning
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Article Overview
This article covers advance care planning in the Medicare physician fee schedule context, focusing on payment, preventive-service billing considerations, and the practical preparation needed to discuss advance directives and related patient forms. It is aimed at physicians, billing staff, and other clinicians who handle end-of-life planning conversations and documentation. The discussion also addresses general workflow, involvement of trained personnel, and the importance of family or proxy participation in these conversations.
Why This Topic Matters
Advance care planning affects both patient communication and reimbursement, so providers need to understand the coverage framework and how to document and support these services appropriately. The article is relevant to practices that want to offer the service, bill it correctly, and prepare staff for conversations about advance directives and related planning documents.
Article Sections
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ACP is a time-based service
This section introduces the service structure and discusses the Medicare billing context for advance care planning. It also addresses the relationship between the service and preventive visit settings.
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Learn forms, but get experts
This section focuses on staff preparation, familiarity with end-of-life planning documents, and the role of appropriately trained personnel. It also discusses general responsibilities during ACP discussions.
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3 ACP tips
This section summarizes practical workflow and patient-engagement considerations for offering advance care planning. It emphasizes availability of materials, outreach, and participation by family members or proxies.
What You Will Learn
- How advance care planning fits into the Medicare physician fee schedule.
- What general billing and documentation considerations apply to ACP discussions.
- Why staff preparation and familiarity with advance directive materials matter.
- How practices can support patient conversations and family or proxy involvement.
Who Should Read This
- Physicians
- Advance practice clinicians
- Medical coders
- Billing staff
- Practice managers
- Healthcare administrators
Codes Discussed
Modifiers Discussed
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