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​​​​​Changes to claim payment policy on care management and care planning services​

October 7, 2022

​Effective November 7, 2022, AmeriHealth HMO, Inc., AmeriHealth Insurance Company of New Jersey, and AmeriHealth Administrators will update their claim payment policy on care management and care planning services for Commercial members.

The policy will be updated to change Advanced Care Planning (ACP) services from “not eligible for separate reimbursement" to “eligible for separate reimbursement." Policy criteria and reporting guidelines will also be provided for ACP services. ACP services are represented by CPT® codes 99497 and 99498.

For more information, please refer to the policy notification for #00.01.59l: Care Management and Care Planning Services, which was published on October 7, 2022.


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