Advance care planning is a crucial step to ensuring that patients get the medical care they want when they are unable to speak for themselves due to illness or injury. Early and frequent conversations among providers, patients, and families about their preferences for end-of-life care can provide the patient with peace of mind that his or her medical wishes will be followed, ease the burden on family members, and prevent unwanted treatment.
While clinical research has found that advance care planning can improve the quality of life for patients with serious, progressive, and potentially fatal conditions, patients rarely initiate these conversations with their doctors and family members. As a result, it’s important for physicians to educate patients about advance care options and encourage them to prepare an advance directive.
Harvard Pilgrim is proud to be a part of the Massachusetts Coalition for Serious Illness Care, a collaborative workgroup with the goal of ensuring that health care for everyone in Massachusetts is in accordance with their goals, values and preferences at all stages of life and in all steps of their care.
A vital component of this work is offering providers the tools needed for these conversations with their patients. Providers across all states can use this Good Talk Toolkit developed by the Coalition to promote the idea of goal setting with their patients, and all of the tools it contains can be customized to your practice/organization.
Our advance care planning coverage
Recognizing the importance of advance care planning, Harvard Pilgrim encourages you to use the following codes to support these important conversations:
- 99497 — Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surrogate
- 99498 — Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (List separately in addition to code for primary procedure)