Advance Care Planning (ACP) refers to the conversation about a patient's future medical treatment wishes.
During an ACP discussion, the patient and provider may or may not complete relevant legal forms, known as advance directives. Advance directive documents that may be referenced during the ACP discussions include:
- Healthcare Agent Appointments
- Living Wills
- Advance Directives for Healthcare (often Healthcare Agent & Living Will forms combined)
- Physician Order for Life-Sustaining Treatment (POLST)
- Out of Hospital Do Not Resuscitate Order (DNR)
ACP Billing
Use the following CPT codes to bill for ACP services:
| Duration | CPT Code | RVUs |
| 15 Minutes or Less | 1123F or 1124F | |
| 16 - 45 Minutes | 99497 | 1.5 |
| 46 Minutes or Greater | 99497 + 99498* | 2.9 |
* Provider should bill an additional 99498 CPT Code for each additional 30 minutes of the ACP discussion
CPT Code Modifiers
Add the following CPT Modifiers when ACP Discussions are billed alongside other Procedures:
| Modifier | Paired Procedure |
| 33 | Preventive Services (ie Medicare Annual Wellness Visit) |
| 25 | Evaluation and Management (E/M) |
Diagnosis
Select the medical Diagnosis code(s) that describe the intent of the Encounter.