Part B Physician/Practitioner Services (Advance Care Planning; Telehealth List); Hospice And Home Health Payment Rules Not Amended By These Sections

The 2027 physician fee schedule adds clinical-staff advance care planning codes and puts them on the telehealth list. What CMS heard about community palliative care

The short answer: CMS's CY 2027 Physician Fee Schedule final rule, published Nov. 9, 2026, at 91 FR 70992, creates two advance care planning codes, G0572 and G0573, for time clinical staff spend under a treating practitioner's direction, and adds both to the Medicare telehealth list. It also summarizes comments on future community-based palliative care but finalizes no new palliative benefit.

CY 2027 PFS final rule (91 FR 70992): new advance care planning codes G0572/G0573 for clinical staff, added to telehealth, plus CMS's palliative care RFI.

By Monsaur OthmanPublished November 11, 2026Last updated November 11, 20264 sources linked

A smiling older woman with curly gray hair and glasses sits at a desk in a living room, hands pressed together, looking at a laptop during a video call — An older woman on a video call at home. CMS is adding the new advance care planning codes to the Medicare telehealth list for 2027. Stock photo; not a patient, and not an advance care planning visit. Photo: Shixart1985 / Wikimedia Commons, CC BY 2.0 (cropped) · CC BY 2.0

Short answer: CMS's CY 2027 Physician Fee Schedule final rule, published Nov. 9, 2026, at 91 FR 70992, creates two advance care planning codes, G0572 and G0573, for time clinical staff spend under a treating practitioner's direction, and adds both to the Medicare telehealth list. It also summarizes comments on future community-based palliative care but finalizes no new palliative benefit.

Key facts (as of Nov. 11, 2026, morning CT) - The rule: CMS-1848-F, FR Doc. 2026-22743, 91 FR 70992–72020, published Nov. 9; effective Jan. 1, 2027. - New codes: G0572 (first 20 minutes of clinical staff advance care planning time) and G0573 (each additional 20 minutes), directed by a treating physician or other treating practitioner. - Billing together: allowed with CPT 99497/99498 when each code set's time threshold is met on its own. - Telehealth: both G-codes join the Medicare Telehealth Services List for 2027. - Palliative care: comments summarized; no new service or payment finalized.

What did CMS finalize for advance care planning?

Two new HCPCS codes for advance care planning (ACP) done by clinical staff. Since 2016, Medicare has paid for ACP under CPT 99497 and 99498, which describe time spent by the physician or other qualified health care professional, the final rule recounts. CMS has let clinical staff time count toward those codes only if the billing practitioner "managed, participated and meaningfully contributed."

CMS says it heard that ACP "may be under-utilized because some practitioners believe that only time they personally spend can count." Its fix, finalized at 91 FR 71188:

G0572: advance care planning, including explaining and discussing advance directives and completing forms when performed, "first 20 minutes of clinical staff time with the patient, family member(s), surrogate directed by a treating physician or other treating qualified health care professional."
G0573: each additional 20 minutes of clinical staff time, reported with G0572. CMS added the words "of clinical staff time" to the final descriptor as a technical correction.

The rule repeats a line from the proposal: "clinicians must not, under any circumstances, attempt to influence their patients' decisions for ACP."

How do the new codes work with 99497 and 99498?

They can be billed together, with limits. CMS finalized that G0572/G0573 and 99497/99498 "could be reported together, if time thresholds by the billing practitioner and clinical staff are each met with these respective code sets." It will also let practitioner time be combined with clinical staff time to reach the G0572 or G0573 threshold when staff time alone falls short. G0573 can be reported only once the full 20 minutes under G0572 has been spent. "The time counted for reporting one service code must not also be counted to meet the time requirements of another service code being reported," CMS wrote.

CMS did not finalize a separate combined-time code some commenters wanted, saying many others warned it would add confusion.

What supervision and staffing rules apply?

The usual "incident to" rules. Many commenters asked for general supervision; CMS instead reiterated that "direct supervision may be satisfied by use of audio-visual technology." It said it is not setting qualifications for the clinical staff, deferring to state requirements under 42 CFR 410.26. A prior visit for the patient's diagnosis or treatment "is presumed," but the ACP service doesn't have to fall on the same day.

Asked whether the staff codes can be used in skilled nursing and nursing facilities, CMS answered only that "consolidated billing rules apply to services furnished by clinical staff in institutional settings." It also said it will update its Advance Care Planning MLN fact sheet "in the near future."

Can advance care planning be done by telehealth in 2027?

The new codes can. CMS finalized adding G0572 and G0573 to the Medicare Telehealth Services List beginning in CY 2027, after commenters "generally supported" the proposal (91 FR 71023–71024). The same section adds several other codes, including G0576, G0686, G0687 and G0903. The final ACP section restates the addition at 91 FR 71190.

What did CMS say about community-based palliative care?

It asked questions and summarized the answers; it did not create a benefit. CMS said it had sought comment, starting in the FY 2027 hospice proposed rule, on palliative services outside the hospice benefit, in clinics, patients' homes and other non-hospital settings. In the fee schedule rule it asked whether eligibility should hinge on life expectancy, daily function or caregiver strain; how care management for seriously ill patients should differ; and how to report quality. It pointed to the CMS Innovation Center's synthesis of palliative care model evaluations.

CMS also wrote that "hospice care is not palliative care" and asked where it should focus on "potential fraud, waste, and abuse in community-based palliative care."

Commenters "broadly supported" community-based palliative services in Original Medicare, CMS reported. They objected to using prognosis as the eligibility test, suggesting criteria such as symptom burden, functional decline, cognitive impairment and caregiver strain, and stressed services for people "prior to hospice election while beneficiaries continue curative or disease-modifying treatment." They "differed on whether home-based capabilities should be required." CMS's full response: "We will use these comments to advise future rulemaking."

What does this mean for home health and hospice providers?

These sections change Part B practitioner billing, not home health or hospice payment. The codes are billed under the physician fee schedule by physicians and other practitioners; nothing in these sections amends home health (part 484) or hospice (part 418) rules. Hospices and home-based programs that work with community physicians may see those practices use the new staff-time codes from Jan. 1. The palliative care comments are a signal of interest, not a rule. For this year's home health payment rule, see our CY 2027 home health final rule explainer.

Sources

Photo: Shixart1985, via Wikimedia Commons, CC BY 2.0 (cropped). Stock photo; not a patient or an advance care planning visit.

Not clinically reviewed. Informational only, not billing, legal or clinical advice. Check the linked primary source and your Medicare Administrative Contractor.

Drafted with AI assistance from primary sources. Written and edited by the Home Health Brief newsroom under Monsaur Othman's editorial standards. Read how we use AI, our editorial policy and our corrections policy.