Reimbursement Information
Providers – You May be Able to Bill for Survivorship Care Planning
“There is a need for this since patient care is so often ignored; a Survivorship plan is a means to address patient concerns and get the right person to address those concerns.” – Oncologist
The treating clinician for Survivorship Care Planning may be able to bill for the total time spent examining and/or counseling the patient. Please check with the patient’s plan before billing as reimbursement is subject to the member’s benefit plan design.
The Survivorship Care Plan should be used as a tool to educate patients about their personal cancer treatment history, the appropriate surveillance for recurrence or second primaries, and the risks of late- and long-term effects.
Regular office visit evaluation and management CPT codes can be used for these visits, if you perform these services. To optimize available reimbursement, make sure that the appropriate office visit code is chosen to reflect the total amount of time spent with the patient. Clearly, it is critical to document the time spent on counseling using the Survivorship Care Plan along with time spent on other tasks, such as a physical examination.
The visit can also be shared with other office staff, such as a nurse, dietician or mental health provider, working under the supervision of the physician. The length and complexity of these visits will vary depending upon the patient’s medical and treatment history. Ideally, this visit using the Survivorship Care Plan will take place during the first follow-up treatment following adjuvant therapy or even later.