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November 2015
In this Issue

  • Medicare will reimburse physicians for advance care planning discussions beginning January 1
    ISMS President
    Scott A. Cooper, MD

    ISMS is immensely proud of our role in helping to initiate this historic payer policy shift. Beginning next year, physicians will be able to bill Medicare for time spent counseling patients on advance care planning decisions.

    Our effort began in 2013 when ISMS submitted an application for the creation of advance care planning codes to the CPT Editorial Panel.

    ISMS was supported by a core team of committed members who helped present the case that reimbursing physicians for advance care planning leads to better patient care.

    The CPT Editorial Panel’s approval of ISMS’ application was the first domino to fall leading up to this national change.

    What followed over the next two years was a sequence of positive news and growing support for payment. Finally, our pursuit culminated in Medicare’s recent announcement that physicians will be reimbursed for their time.  Many private insurers follow Medicare’s reimbursement lead, so we are hopeful that payment for these services will soon be commonplace.

    Under the new rule:

    • Reimbursement for the first 30 minutes of advance care planning will be $86 in office settings and $80 in hospitals (CPT code 99497).
    • Medicare will reimburse up to $75 for 30 additional minutes of consultation (CPT code 99498).

    ISMS is committed to engaging patients in their health care decision-making. Our A Personal Decision planning guide is available to anyone for free download. ISMS members can request up to 300 free print copies each year by contacting purchasing@isms.org or calling 800-782-4767.

    Thank you for supporting ISMS advocacy through your membership.  We can’t do it without you!

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