Medicare Proposes Paying for End-of-Life Counseling in Sweeping Physician Payment Rule

In a draft of Medicare's first physician payment rule since Congress scrapped the sustainable growth-rate formula, the CMS proposes paying for end-of-life counseling and revises several quality-incentive programs that will be rolled into a new comprehensive program in 2019. 

The proposed changes to the 2016 Medicare Physician Fee Schedule (PDF) includes a provision activating two new advance care-planning codes and assigning them value. These codes would be used to pay for a provider's time discussing patient choices for advance directives and completing necessary forms. One code would cover the first 30 minutes and the other would cover any additional 30-minute blocks that are needed.

The American Medical Association/Specialty Society Relative Value Scale Update Committee, better known as the RUC, developed those codes. The CMS wrote that it is proposing to adopt the RUC-recommended values beginning Jan. 1, 2016, and will “consider all public comments” it receives. The proposed fee schedule did not include the RUC-recommended payments for these codes and the CMS emphasized that it was not setting a value at this time.

The activation of the code “does not mean that Medicare has made a national coverage determination regarding the service,” the agency said in the rule. “Contractors remain responsible for local coverage decisions in the absence of a national Medicare policy.”