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Wisconsin Medical Society praises inclusion of advance care planning in Physician Fee Schedule

Release Date: July 9, 2015
Contact: Kendi Parvin - 608.442.3748 kendi.parvin@wismed.org

MADISON (July 9, 2015) — The Wisconsin Medical Society today praised the Centers for Medicare and Medicaid Services’ inclusion of advance care planning for reimbursement in its 2016 Physician Fee Schedule Proposed Rule. The provision will significantly improve patient access to advance care planning across Wisconsin.

“Advance care planning conversations are so important,” said Donn Dexter, MD, the Society’s chief medical officer. “As a neurologist, I’ve seen firsthand the benefits to patients and families when they have these conversations, and the stress and conflict that often result when they don’t.

“We fully support maintaining this provision in the Final Rule, and advocate for reimbursement to begin Jan. 1, 2016,” Dr. Dexter continued.

Advance care planning is an ongoing process of understanding, reflecting on and discussing future medical decisions, including end-of-life preferences. It includes:

  • Understanding health care treatment options.
  • Clarifying health care goals.
  • Weighing options about what kind of care and treatment a patient would want or not want.
  • Appointing a health care agent and/or completing an advance directive.
  • Communicating wishes and any documents with family, friends, clergy, other advisors and physician and other health care professionals.

Through its Honoring Choices Wisconsin program, the Wisconsin Medical Society has been working to make advance care planning a routine and standard part of care.

“Honoring Choices participants have been building and improving advance care planning for several years, but lack of reimbursement has been a significant disincentive to their growth and sustainability,” said John Maycroft, director of policy and development initiatives. “This will reward Wisconsin health care teams for doing the right thing and help keep us a national leader in advance care planning.”

The new reimbursement codes are:

  • 99497—Advance care planning, including the explanation and discussion of advance directives such as standard forms (with completion of such forms and when performed), by the physician or other qualified health care professional; the first 30 minutes, face-to-face with the patient, family member(s), and/or surrogate.
  • +99498—For each additional 30 minutes.

With more than 12,500 members dedicated to the best interests of their patients, the Wisconsin Medical Society is the largest association of medical doctors in the state and a trusted source for health policy leadership since 1841. For more information about Honoring Choices Wisconsin, visit www.honoringchoiceswi.org.

The name “Honoring Choices Wisconsin” is used under license from Twin Cities Medical Society Foundation.