Advanced care planning codes are now covered

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Advanced care planning codes are now covered

01/06/2016

ConnectiCare began covering advanced care planning (ACP) services with codes 99497 and 99498 for our commercial and Medicare plan members on Jan. 1, 2016. Please submit any claims with these codes after March 31, 2016.

Please note, these services will be exempt from a member cost-share for your patients with ConnectiCare VIP Medicare plans when billed with an annual wellness visit. If, however, services with these codes are billed with an evaluation and management (E&M) service, a member cost-share will apply.

A member cost-share will continue to apply for services with these ACP codes for all patients with ConnectiCare's commercial plans.

Our systems are currently being configured to accept these codes. Please submit any claims with these codes after March 31, 2016. If these codes are submitted before this date, the claims may be denied.