Medicare Bill Eliminates Copays and Deductibles for Advance Care Planning Starting 2027

This legislation, the Improving Access to Advance Care Planning Act, is a major upgrade to how Medicare handles end-of-life and future healthcare discussions. Simply put, the bill ensures that Medicare pays for the conversations you have with your doctor, nurse practitioner, or clinical social worker about your healthcare wishes—like whether you want specific life support measures or who you want making decisions for you if you can’t. These are called “advance care planning services.”

The Cost Barrier Drops to Zero

The biggest headline for anyone on Medicare Part B is the financial change coming in 2027. Currently, even if Medicare covers a service, you often have to pay a copay or coinsurance, and you definitely have to meet your annual deductible first. This bill eliminates all of that for advance care planning services starting January 1, 2027. That means no copay, no coinsurance, and the standard Part B deductible won’t apply. For regular folks trying to manage healthcare costs, this is huge: the price tag for ensuring your future wishes are documented correctly goes from ‘something’ to zero dollars out-of-pocket.

Crucially, Medicare will pay for these discussions without requiring you to have an annual wellness visit or physical exam first. This separates the planning conversation from routine checkups, making it easier for patients to schedule these important talks whenever they feel ready. The law specifies that Medicare will only pay one provider for these services during a specific period, which should prevent excessive billing while still allowing necessary planning.

Telehealth and the Remote Revolution

If you live in a rural area or simply have a packed schedule, this bill makes access much simpler. Effective immediately, the usual geographic restrictions that apply to telehealth services are waived for advance care planning. This means you can have these sensitive, complex planning sessions with your eligible provider over video chat, regardless of where you or your provider are located. For a caregiver juggling work and family responsibilities, being able to handle this from home saves time and gas money, making a difficult conversation a little bit easier to manage.

Expanding the Eligibility Pool

To ensure there are enough people to provide these services, the bill defines who can get paid by Medicare for leading these discussions. The list includes doctors, physician assistants, and nurse practitioners. It also specifically includes clinical social workers, provided they have a specific care planning certification or documented experience. This is where the bill gets a little vague: the Secretary of Health and Human Services (HHS) gets to define what that “documented experience” looks like, and they can approve other types of practitioners later. While this flexibility is good for expansion, it does hand a lot of administrative discretion to HHS to set the actual standards.

Training the Trainers and Checking the Score

Because this is a major change, the bill mandates that HHS must launch a complete, one-time education campaign to inform doctors and other eligible providers that they can now bill Medicare for these services using specific codes (HCPCS codes 99497 and 99498). If providers don't know they can get paid, the service won't be offered, so this outreach is essential for implementation.

Finally, the bill tasks the Medicare Payment Advisory Commission (MedPAC) with studying how all of this rolls out. By June 2027, MedPAC has to report back to Congress on who is offering these services, how long the visits are, and what barriers are preventing providers and patients from using them. This is the government’s way of checking the work, ensuring that the new coverage is actually translating into better care access on the ground.