We appreciate the advance care planning (ACP) discussions you have with your patients, as this remains an important and valuable service that can significantly improve the overall quality of a patient’s end-of-life care. Encourage regular discussion, at least once per year during an annual visit, as wishes may change over time. Knowing what’s important to your patients may allow for more focused care.

Reminder of Documentation Requirements

Specific elements must be documented during ACP discussions, including the patient’s wishes and at least five of the following elements. If time is the predominant factor, also document the length of the discussion.

  • Person designated to make decisions on behalf of the patient
  • Treatment options and expectations for the patient’s advanced conditions
  • Patient’s preferred comfort level
  • Patient consent for ACP performed as part of an annual wellness visit
  • How patient prefers to be treated by others
  • What the patient wishes family to know about heath conditions
  • What prompted the discussion
  • Whether advance directives are completed

CPT Codes

99497 – initial 30 minutes of face-to-face counseling

99498 (add-on code if applicable) – additional 30-minute discussion

When applicable, also document discussion of diagnosis, prognosis and treatment options along with risks, benefits and the likelihood of success or failure.

Helping patients understand that they have options—and that the earlier planning begins, the better—is vital. As the patient’s trusted physician, you are in a unique position to educate on the topic and offer insight through ACP discussions into expected health.