End-of-Life Planning Conversations To Get Medicare Reimbursement

November 25, 2014

On October 31st, Medicare announced that it is considering paying doctors for having conversations about end-of-life options with their patients.

This statement followed a New York Times article in August reporting that the American Medical Association (AMA) has created billing codes for end-of-life conversations and submitted them to Medicare for consideration. That in and of itself is significant, although not a guarantee that Medicare will reimburse physicians for this activity. Many private insurers and some states, including Colorado and Oregon, already reimburse doctors for these “advance care planning” conversations.

While many doctors have informal conversations with their Medicare patients about their end-of-life wishes, and encourage them to complete advance directives (also known as health care powers of attorney), this proposed change to Medicare would formalize the process and reimburse doctors for the time they spend.

If the codes for reimbursement submitted to the AMA in August are accepted, Medicare might begin covering end-of-life discussions as early as 2016.

“We think it’s really important to incentivize this kind of care,” said Dr. Barbara Levy, chairwoman of the AMA committee that submits reimbursement recommendations to Medicare. “The idea is to make sure patients and their families understand the consequences, the pros and cons and options so they can make the best decision for them.”

As people are living longer, many want to play a more active role in these decisions about the kind and amount of care they receive at the end of their lives.

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