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Frequently Asked Questions

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Are there limits on how often CPT codes 99497 and 99498 can be billed?

The Centers for Medicare & Medicaid Services (CMS) did not establish any frequency limits. However, when these services are billed multiple times for a given beneficiary, there should be a documented change in the beneficiary’s health status and/or wishes regarding his/her end-of-life care. CPT does not have limits on the number of times ACP can be reported for a given beneficiary in a given time period.

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