CMS Pub. 100-04, ch. 18, § 140.8

(AWV)

(Rev. 10456, Issued: 11-13-20, Effective: 04-01-21, Implementation: 04-05-21)

For services furnished on or after January 1, 2016, Advance Care Planning (ACP) is treated as a preventive service

when furnished with an AWV. The Medicare coinsurance and Part B deductible are waived for ACP when furnished

as an optional element of an AWV.

The codes for the optional ACP services furnished as part of an AWV are 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 professional; first 30 minutes, face-to-face with the patient,

family member(s) and/or surrogate;) and an add-on code 99498 (each additional 30 minutes (List separately in

addition to code for primary procedure)). When ACP services are provided as a part of an AWV, practitioners would

report CPT code 99497 (and add-on CPT code 99498 when applicable) for the ACP services in addition to either of

the AWV codes (G0438 or G0439).

Note: ACP services are payable in hospice (Types of Bill 081x or 082x) when not part of the AWV when the services

are performed by attending physicians that are employed by, or under arrangement with, the hospice.