Emergency Physicians Rarely Bill for Advance Care Planning

By Stacey Kusterbeck, Special for ReliasMedia.com

Clinicians have been able to obtain reimbursement for advance care planning since the Centers for Medicare & Medicaid Services added billing codes to allow healthcare providers to bill for this service in 2016. However, few clinicians actually do.

“We wanted to ask how often emergency physicians [EPs] billed this service as part of the emergency department visit, and to compare this frequency with those of other specialties,” says Adrian Haimovich, MD, PhD, a physician scientist researcher in the department of emergency medicine at Beth Israel Deaconess Medical Center in Boston.

Haimovich and colleagues analyzed 269,013 claims with an advance care billing code in 2018. EPs represented only 0.5% of those claims. “For the right patient, ED-based advance care planning can make a critical impact on their health trajectory,” Haimovich asserts.

It is rare for EPs to engage in advance care planning conversations with patients. Additionally, many EPs do not know the billing criteria to use even if they do engage in such discussions.

Haimovich suggests EPs who would like to promote advance care planning in their departments do the following:

• Talk to department leadership about the role of advance care planning for ED patients.
• Discuss billing criteria with hospital coders to ensure the service is documented correctly to obtain reimbursement.

“ED providers should be aware of the opportunity to provide this important service to their patients, while also being compensated for their effort by Medicare,” Haimovich says.

For more on this and other related subjects, be sure to read the latest issues of ED Management, Hospital Case Management, and Medical Ethics Advisor.