CAPC Billing Tool FAQs

The CAPC Billing Tool is an interactive decision-support resource designed to help clinicians determine appropriate billing code options for palliative care encounters. By answering a series of targeted questions about a patient visit, users receive billing code recommendations, associated wRVUs, documentation requirements, and educational guidance. The tool provides tailored coding recommendations and clear documentation support, reducing the guesswork and helping clinicians bill accurately and in compliance with applicable billing requirements.

The tool is intended for physicians, advanced practice providers, and other clinicians involved in billing for specialty palliative care services. It may also be useful for practice leaders, billing staff, and administrators seeking to strengthen team competency over time. Other non-procedural providers like primary care clinicians and hospitalists who bill for evaluation and management services may also find this tool useful.

Users answer a series of questions about a patient encounter, including visit characteristics and clinical complexity. The tool then provides:

• Billing code options
• Associated work RVUs (wRVUs)
• Documentation requirements
• Billing guidance and rationale for code selection

Watch this video for a tutorial on how to use the CAPC Billing Tool.

Yes. The tool provides guidance for billing based on medical decision-making, helping clinicians understand which factors support specific coding levels. The tool includes guidance on billing based on time and helps users understand when time-based billing may be appropriate.

Yes, the CAPC Billing Tool will be reviewed annually and updated as needed to align with the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule and other relevant coding and payment policy changes.

Disclaimer: The information provided in this tool is for general knowledge and informational purposes only and does not constitute medical billing advice. Health professionals must seek specific interpretation and advice from their local billing compliance staff, insurance partners, and the Centers for Medicare & Medicaid Services (CMS). Reliance on any information provided in this tool is solely at your own risk.

Yes. Your subscription includes access to an on-demand training session featuring Chris Jones, MD and Phil Rodgers, MD, which provides instruction on palliative care billing and coding principles.

In addition, CAPC Members have access to other billing resources, including:

• Billing and Coding Toolkit
• Virtual Office Hour: Inpatient Billing and Coding
• Virtual Office Hour: Billing for Community-Based Palliative Care

Currently, the CAPC Billing Tool does not offer Continuing Education credits.

The CAPC Billing Tool is available through an annual subscription for $49 per user, billed on a rolling 365-day cycle. To continue access after your subscription period ends, you will need to renew your subscription.

The CAPC Billing Tool is available to both CAPC members and non-members; organizational membership is not required to purchase.

No. Individual subscriptions are licensed per user.

After purchasing the CAPC Billing Tool, you'll receive immediate access to both the on-demand training session and the CAPC Billing Tool, along with a confirmation email. You can access these resources during your subscription period by logging in to your CAPC account and visiting your Dashboard, where links to the Billing Tool and training session will be available.

The Billing Tool is optimized for modern browsers, including Google Chrome, Mozilla Firefox, Microsoft Edge, and Safari. For the best experience, please use the most up-to-date version of your browser.

Yes. The tool is responsive and can be accessed on tablets and most mobile devices. For ease of data entry and visibility, we recommend using a desktop or laptop when possible.

No downloads are required. The tool is entirely web-based; log in through your browser and get started.

Yes. Because the tool is web-based and updated regularly, a stable internet connection is required to use it.

No. The tool does not save patient information or encounter data between sessions.

By using the CAPC Billing Tool, you agree to CAPC’s Terms of Use and Privacy Policy. Access is limited to licensed individuals, and any misuse may result in loss of access.

If you're experiencing login issues, try resetting your password or clearing your browser cache. If the issue persists, please contact CAPC support.

If your question wasn’t answered in these FAQs, please contact CAPC support.