Advanced Care Planning

Table of Contents

• Billing Codes
• Billing Information
• Documentation
• Related Content

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Billing Codes

• 99497: 30 minutes
• 99498: each additional 30 minutes

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Billing Information

Medicare waives ACP coinsurance and Part B deductible when ACP is:

• Rendered on the same day as a covered annual wellness visit. (HCPCS codes G0438 or G0439)
• Offered by the same provider as a covered annual wellness visit.
• Billed with modifier 33. (preventive services)

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Documentation

Documentation to support ACP should include:

• The total time spent, must be documented in the medical record
• Advance care planning is a preventive service only when it’s provided in conjunction with an annual wellness visit, and reported with modifier 33

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Related Content

• Helpful Reminders on Advance Care Planning
• MLN® Fact Sheet: Advance Care Planning
• Advance Care Planning Services FAQs
• Care Management

Revised 4/18/2024