CMS recently accepted two Current Procedural Terminology reimbursement codes for conversations about end-of-life treatment, according to the American Medical Association.
Still, use of the codes remains low, according to a study published in JAMA Internal Medicine, which could indicate physicians face barriers to documenting end-of-life discussions.
Here, five key notes about billing for end-of-life care are discussed.
- For an advance-care planning billing code to be reimbursable, physicians must hold the conversations in person and document them in an EHR.
- CPT code 99497 is used for the first 30 minutes, paying about $86 for outpatient visits and $80 for inpatient visits. Thereafter, CPT code 99498 is used to pay $75 for each additional 30 minutes, according to the AMA.
- In the JAMA study, researchers analyzed fee-for-service Medicare Part B claims in 2016 and part of 2017, and found billing rose from 1.9 percent of beneficiaries in 2016 to 2.2 percent in 2017. However, while advance-care planning billing grew, the study also found most physicians who are likelier to have end-of-life conversations with patients aren’t using the codes.
- The results varied significantly by state. Advance-care planning billing rates ranged from less than 1 percent in some states to 10.4 percent in others.
- Specialty also affected billing rates for advance-care planning. Hospice and palliative care medicine saw the largest increases. While the share of physicians using an advance-care planning code at least once was 27.6 percent in 2016, the share grew to 35.9 percent in 2017.
Date: July 11, 2019
Source: Becker’s Hospital Review