Policy Statement
Palliative care services are specialized medical care for people living with serious illness who may have more focused medical goals depending on their prognosis. Care is focused on providing patients with relief from symptoms, pain and stress of a serious illness regardless of the prognosis. The individual providers that can provide palliative care can include but are not limited to:
- Physician
- APRNs - Includes Clinical Nurse Specialists (CNSs) and Nurse Practitioners (NPs), depending on state regulations on scope of practice
- Physician Assistant/Physician Associate
- Social Worker
Acceptable Current Procedural Terminology (CPT®)/Healthcare Common Procedure Coding System (HCPCS)/Rev Codes for facilities:
- 99509 and revenue code 0691 - Pre-hospice/Charge Home Visit for assistance with Activities of Daily Living and Personal Care
- 99510 and revenue code 0691 - Pre-hospice/Charge Home Visit for Individual, Family, or Marriage Counseling.
Acceptable CPT/HCPCS Codes for professionals:
- 99497 and 99498 can still be billed as palliative care and will be subject to general medical benefits.
References
Cross References
- Adm 148 – Incident to Services
