Making Sense of MACRA: Advance Care Planning


You can get paid for advance care planning and satisfy a high-priority quality measure for MACRA.

Fam Pract Manag. 2018 Jan-Feb;25(1):9-10.

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Discussing end-of-life decisions with your patients and their family members can be difficult and uncomfortable. As a patient’s primary care provider, family physicians are ideally suited to facilitate this conversation.

Advance care planning (ACP) enables patients and families to have this important end-of-life conversation with their family physician. The patient can discuss their wishes and preferences about the type of treatment and care he or she wants to receive during the latter stages of life. The Centers for Medicare & Medicaid Services (CMS) defines ACP as the face-to-face time a physician or other qualified health care professional spends with a patient, family member, or surrogate to explain and discuss advance directives.


Starting January 1, 2016, CMS began paying for ACP services for traditional Medicare beneficiaries. ACP is one of four care management codes highlighted by the American Academy of Family Physicians (AAFP) that can optimize payment now, while preparing for value-based care. ACP can satisfy a high-priority quality measure for reporting in the Medicare Access and CHIP Reauthorization Act (MACRA). There are two current procedural terminology (CPT) codes used to report and file claims for ACP services: 99497 and 99498.

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