| Modifier | Paired Procedure |
| 95 | Telehealth Service |
| 33 | Annual Wellness Visit |
| 25 | Evaluation & Management (E/M) |
When may ACP CPT codes be reported?
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If ACP is the primary service delivered in a patient visit, an advanced care planning CPT code (1123F, 99497) can be used alone.
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E/M and ACP can be provided on the same day. Both codes should be reported with modifier-25 added.
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ACP can be reported during a Medicare AWV. The CPT code should be reported with modifier-33 added to avoid a patient copay.
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ACP can be reported on the same day as Transitional Care Management (TCM) and Chronic Care Management (CCM) services.
- If ACP is performed via telehealth the modifier 95 should be added along with the appropriate CPT code.