Administration
Chapter 1
Section 14.3
Advance Care Planning (ACP) Services
Issue Date: July
19, 2016
Copyright: CPT only © 2006
American Medical Association (or such other date of publication
of CPT). All Rights Reserved.
Revision: C-1,
March 10, 2017
1.0 CPT Codes
99497,
99498
2.0 Description
ACP
services are face-to-face consultation services between a TRICARE-authorized
provider and a patient, family member, or surrogate for the purpose
of discussing end-of-life care planning. These services may also
include the completion of advance directive documents such as:
• Healthcare Proxy;
• Durable Power
of Attorney for Health Care;
• Living
Will and Medical Orders for Life-Sustaining Treatment.
3.0 Policy
3.1 ACP services
are covered when provided in connection with medically and psychologically necessary
treatment of an injury or illness in an outpatient, inpatient, or
Skilled Nursing Facility (SNF) setting.
3.2 Cost-sharing and copays apply.
4.0 Exclusion
ACP
services are not covered when provided in connection with a preventive
services office visit (e.g., CPT codes
99381-99387 and 99391-99397).
5.0 Effective
Date
January 1, 2016.
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