CMS to Cover Audio-Only Advance Care Planning During Pandemic

Health care providers are able to bill Medicare for advance care planning services conducted via audio-only telehealth consultations on a temporary basis during the COVID-19 national emergency. 

Due to provisions in the CARES Act pandemic stimulus package, the U.S. Centers for Medicare & Medicaid Services (CMS) has the authority to expand the use of telehealth for the duration of the federal disaster declaration associated with the pandemic. The advance care planning move, which is pursuant to an 1135 waiver, is the latest in a series of actions by CMS that allow hospices and other providers to offer more services via telehealth, including re-certification of patients for hospice and some routine home care visits.

The agency continues to require both a video and audio connection for most telehealth services.

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“This waiver allows the use of audio-only equipment to furnish services described by the codes for audio-only telephone evaluation and management services, and behavioral health counseling and educational services,” the agency indicated. “Unless provided otherwise, other services included on the Medicare telehealth services list must be furnished using, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and distant site physician or practitioner.”

The agency has published a list of billing codes that apply to telehealth services allowable during the pandemic.

Declaration of a national disaster allows the U.S. Secretary of Health and Human Services (HHS) to waive or modify certain Medicare requirements under section 1135 of the Social Security Act.

Through advance care planning, patients make clear their wishes and goals for end-of-life care and communicate that information to their clinicians as well as their families. Advance care plans also typically include the patient’s designated surrogate who can make health care decisions in their stead should the patient become incapacitated.

According to a 2017 report published by the Kaiser Family Foundation and The Economist, a little over half of people in the United States had end-of-life conversations with loved ones, with less than 20% having these discussions with their providers. Only 27% had formally documented their wishes in advance directives or Physician Orders for Life-Sustaining Treatment (POLST) forms.