New Advance Care Planning Codes G0572 and G0573
Clinical-Staff ACP Under Direct Supervision, and a Narrower 99497/99498
Summary of the Rule or Edit Change
The CY 2027 Medicare Physician Fee Schedule final rule (published November 4, 2026) splits advance care planning into two distinct billing lanes. CPT 99497 (first 30 minutes) and 99498 (each additional 30 minutes) still exist, but CMS has narrowed them to count only the time the billing practitioner personally spends with the patient or family discussing advance directives. That's a real change from how a lot of practices have been documenting these visits, where clinical staff time sometimes got folded into the practitioner's total.
To cover the clinical-staff side of the conversation, CMS created two new codes, G0572 and G0573, specifically for advance care planning services furnished by clinical staff under the billing practitioner's direct supervision. In plain terms: if your office has a nurse or care coordinator who spends time walking a patient through advance directive paperwork separately from the physician's own counseling time, that work now has its own code rather than getting absorbed into (or lost from) the 99497/99498 total.
Action Required for Billing Teams
- Update your ACP documentation templates to separate physician/practitioner time from clinical-staff time as two distinct entries, not one blended total.
- Train staff who conduct ACP conversations under supervision to log their own time against G0572/G0573 once the codes are active for 2027 dates of service.
- Re-audit any ACP claims where 99497/99498 time included clinical-staff minutes; that pattern won't hold up under the narrowed 2027 definition.
- Confirm your EHR's direct-supervision attestation covers the new codes before go-live.
For the full specialty-by-specialty breakdown of everything else in this rule, read our CY 2027 Medicare Physician Fee Schedule RCM guide.
Verifiable References
- CMS. Calendar Year (CY) 2027 Medicare Physician Fee Schedule Final Rule (fact sheet). cms.gov/newsroom/fact-sheets/calendar-year-cy-2027-medicare-physician-fee-schedule-final-rule
- American Hospital Association. CMS Issues CY 2027 Physician Fee Schedule Final Rule. aha.org/news/headline/2026-11-04-cms-issues-cy-2027-physician-fee-schedule-final-rule
Related Resources
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