End of Life Care/Advance Care Planning

1.6.16: Medicare Coverage of Advance Care Planning     

A REMINDER:

On January 1, 2016, Medicare began covering advance care planning as a separate and billable service.

The two advance care planning codes for Medicare are:

  • 99497 for an initial 30 minute voluntary advance care planning consultation (Final RVU 1.5)
  • 99498 as an add-on code for additional 30 minute time blocks needed (Final RVU 1.4)

-- Review the FAQ document developed by the Henry J. Kaiser Family Foundation for more information on Medicare’s role in end-of-life care and advance care planning.


11.8.15: Advance Care Decisions Materials Available from NYACP

Advance decision making and end-of-life care options are unfortunate but necessary conversations for patients to have with their physicians and families. New York Chapter ACP has gathered important resources to assist in making these difficult discussions a reality.

A recently released report from the Institute of Medicine of the National Academies entitled “Dying In America: Improving Quality and Honoring Individual Preferences Near the End of Life” details key findings and recommendations related to the realities of the clinician-patient relationship and how to effectively communicate and facilitate end of life wishes and directives.  An excerpt of the recommendations:

“Most people nearing the end of life are not physically, mentally, or cognitively able to make their own decisions about care. The majority of these patients will receive acute hospital care from physicians who do not know them. Therefore, advance care planning is essential to ensure that patients receive care reflecting their values, goals, and preferences.”

You can read the document in its entirety here.


MOLST Resources

The Department of Health for New York State has a website of resources including the Medical Orders for Life-Sustaining Treatment (MOLST) form.

The DOH has created a portal that contains a wealth of information on advance care decisions, including legal requirements checklists, frequently asked questions, and guidance documents for physicians and patients.

MOLST legal requirements checklists and general instructions for adult patients are:

The MOLST legal requirements checklist for minor patients is:

Frequently Asked Questions regarding MOLST:

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