The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) to make payment for Advance Care Planning according to system changes. CMS has made the CPT code 99497 for Advance Care Planning (ACP) separately payable for Medicare OPPS claims when the service meets the criteria for separate payment under OPPS. A Medicare Physician Fee Schedule Database (MPFSDB) update establishes this change. Contractors shall assess deductibles and coinsurance and otherwise evaluate claims with regard to this update.
Subject: Advance Care Planning (ACP) Implementation for Outpatient Prospective Payment System (OPPS) Claims
Title: Change Request 9862
Release Date: Feb. 10, 2017
Effective Date: Jan. 1, 2017
Implementation Date: July 3, 2017
Special Notes: N/A