Advance Care Planning Billing
It is common for hospitalists to have advance care planning discussions and address advance directives with patients (and families) during an admission for a serious life-threatening condition or end-stage chronic disease. Medicare waives the coinsurance and the Medicare Part B deductible for ACP when: ● Provided on the same day as a covered AWV ● Furnished by the same provider as a covered AWV ● Billed with modifier –33 (Preventive Services) Voluntary ACP is considered a preventive service when billed with the AWV on the same day by the same provider, so CMS waives the deductible and coinsurance for ACP. When AWV is medically necessary and billed with ACP, but the AWV is denied for exceeding the once-per-year limit, payment can still be made for the ACP. In that case, CMS applies the deductible and coinsurance to the ACP service. The deductible and coinsurance DOES apply when ACP is provided outside the covered AWV. NOTE: Critical Access Hospitals (CAHs) may bill for ...