ACP: Advance Care Planning
Documented advance directive or surrogate decision-maker.
Measure description
Documented advance directive or surrogate decision-maker.
Eligible population
Older adults
Performance drivers
Part of Care for Older Adults composite.
Documentation & PA strategy
Annual AWV: discuss + document ACP. CPT 99497/99498.
Why HEDIS matters for prior authorization
Health plans align prior authorization criteria with HEDIS measures: documenting your patient meets the HEDIS definition often streamlines or eliminates PA hurdles. For Medicare Advantage in particular, plans are heavily incentivized via Star Ratings to push members and providers toward measure compliance, which translates into faster approvals for measure-aligned services.
Frequently asked questions
What does HEDIS measure ACP measure?
Documented advance directive or surrogate decision-maker.
What drives performance on this measure?
Part of Care for Older Adults composite.
How should clinicians document for this measure?
Annual AWV: discuss + document ACP. CPT 99497/99498.
What is the eligible population?
Older adults
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