Medicare May Pay for End-of-Life Talks

Mark Crane

November 03, 2014

Medicare is again considering paying physicians for end-of-life counseling and discussions about advance directives.

Any change won't happen until 2016. The Centers for Medicare & Medicaid Services (CMS) is responding to a request made last August from the American Medical Association (AMA) that proposed a new billing code for physicians who provide counseling to patients who want end-of-life directives.

"Since the request for separate payment was received after the proposed rule, the final 2015 physician fee schedule does not include payment for voluntary face-to-face discussions on advance care directives," a CMS statement noted.

"However, CMS intends to consider whether to pay for this voluntary consultation through the regular rulemaking process in order to give the public ample opportunity to weigh in on this topic," CMS said.

Several private health insurance companies that cover about 12 million of the nation's 50 million elderly beneficiaries through Medicare Advantage plans already provide coverage for end-of-life counseling.

"We think it's really important to incentivize this kind of care," Barbara Levy, MD, chairwoman of the AMA committee that recommends reimbursement codes, told The New York Times in August. "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."

Earlier this year, Senators Tom Coburn (R-Okla.) and Chris Coons (D-Del.) proposed a law that would encourage advance directives. Rather than pay doctors, they would have Medicare pay $75 directly to any senior who writes an advance directive and makes it available to their caregivers.

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