Advance Care Planning: Your Chances of Getting Paid for End-of-Life Services Just Got Better

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article covers Medicare reimbursement changes affecting advance care planning services and related physician fee schedule updates for 2016. It is relevant to physicians, other qualified health care professionals, coders, and billing staff who need a general understanding of the new payment policy, how CMS described the services, and the broader fee schedule changes discussed in the Final Rule and CMS Fact Sheet.

Why This Topic Matters

It helps readers understand when Medicare payment became available for advance care planning services and why overall physician reimbursement expectations changed under the 2016 Final Rule.

Article Sections

  1. Medicare payment for advance care planning services

    This section summarizes CMS payment policy for advance care planning and the general context for Medicare beneficiaries. It also introduces the CPT code-based services discussed in the article.

  2. Payment is set

    This section discusses the assigned payment resources for the advance care planning services and the related reimbursement context. It also notes how the article frames the change for providers.

  3. Reporting and documentation considerations

    This section describes the article’s general guidance on where the services may be reported alongside other types of care and highlights documentation expectations. It also mentions service categories addressed in the Final Rule.

  4. Look for Conversion Factor to Drop

    This section summarizes the article’s discussion of the physician fee schedule conversion factor change and the broader payment impact described in the Final Rule. It also references the MACRA-related expectations discussed by CMS.

What You Will Learn

  • How CMS addressed payment for advance care planning services under the Medicare Physician Fee Schedule
  • What types of fee schedule updates were discussed in the 2016 Final Rule
  • What general documentation and reporting topics are associated with the policy change
  • How the article frames the conversion factor change and its effect on overall Medicare payment expectations

Who Should Read This

  • Physicians
  • Other qualified health care professionals
  • Medical coders
  • Medical billing staff
  • Practice managers

Codes Discussed


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