Sec. 5. Enhancing coverage of advance care planning services
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Section 1861 of the Social Security Act ( 42 U.S.C. 1395x ) is amended by adding at the end the following new subsection: The term advance care planning services means services identified as of the date of enactment of this subsection as Current Procedural Terminology
(CPT)codes 99497 and 99498, and such codes as subsequently modified, that are furnished by a physician or other eligible practitioner (as determined by the Secretary). For purposes of paragraph (1), the term eligible practitioner includes, in addition to a practitioner eligible to bill such CPT codes as of the date of enactment of this subsection, an individual who— is a clinical social worker (as defined in subsection (hh)(1)); and possesses— a relevant care planning certification; or experience providing care planning conversations or similar services, as defined by the Secretary, in the course of their work. . Section 1833(a)(1) of the Social Security Act ( 42 U.S.C. 1395 l (a)(1)) is amended— by striking and
(BB)and inserting
(BB); and by inserting before the semicolon at the end the following: , and
(CC)with respect to advance care planning services (as defined in section 1861(jjj)(1)), the amounts paid shall be 100 percent of the lesser of the actual charge for the services or the amount determined under the fee schedule established under section 1848(b). . The first sentence of section 1833(b) of the Social Security Act ( 42 U.S.C. 1395l(b) ) is amended— by striking and before
(10); and by inserting before the period the following: , and
(11)such deductible shall not apply with respect to advance care planning services (as defined in section 1861(jjj)(1)) . The amendment made by this subsection shall apply to advance care planning services furnished on or after January 1, 2018.
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