Recent Trends in the Use of Medicare Advance Care Planning Codes

Advance Care Planning (ACP) is associated with increased hospice use and palliative care, decreased use of life-sustaining treatments, and greater patient and family satisfaction and peace of mind.The emergence of the COVID-19 pandemic, with its associated high mortality rate and potential need to ration scarce resources, has brought ACP to the forefront of public discourse. The Centers for Medicare and Medicaid Services (CMS) began payment for ACP services in 2016, but uptake has been slow. In this report we extend previous evaluations of ACP billing code usage to understand trends in uptake by patients and in the use of codes by providers covering the first three years of the policy change.