Ideally, providers complete an Advance Care Planning discussion during the patient’s Medicare Annual Wellness Visit.
For patients with FFS insurance coverage, there is no cost incurred by the patient when an ACP conversation takes place during the Wellness Visit, but ACP adds a significant addition to the reimbursement of the AWV service with no added copay by the patient.
There are no frequency limits to the number of times that an ACP can be billed for a patient. When a patient gets ACP services outside of AWV, the patient should be told that the Part B cost sharing (deductible and coinsurance) applies. Article - Billing and Coding: Advance Care Planning (A58664) (cms.gov)
There are reasons to have an ACP conversation outside of annual wellness visits - for example if a patient had a stroke and was hospitalized that may be a good reason to revisit the conversation.