The Centers for Medicare & Medicaid Services proposed yesterday to pay physicians for optional end-of-life discussions, according to a Medscape report. The reimbursements would begin in the first half of 2016.
Here are four things to know, according to the report:
1. CPT codes 99497 and 99498 have been introduced in its physician fee schedule for this year, but are not payable. The first code covers a discussion of advance directives up to 30 minutes, and the second code covers an extra 30 minutes.
2. The draft regulation to activate the two codes does not necessarily mean Medicare has made a national decision regarding "advance-care planning."
3. The decision on reimbursement for an active billing code will fall on the MACs, often private health insurers who process the claims, and Medscape is reporting that if the proposal becomes final, MACs would pay for the new codes unless they contest them, even if end-of-life treatments do not become a national policy.
4. CMS is accepting public comments on this proposal, as part of the CY 2016 PFS proposed rule, until September 8, 2015.