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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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