Use of Advance Care Planning Codes Among Transgender Medicare Beneficiaries.

<b><i>Purpose:</i></b> We examined the use of advance care planning (ACP) among Medicare beneficiaries who were identified as transgender. <b><i>Methods:</i></b> This study is a cross-sectional analysis of Medicare claims from 2016 to 2018, comparing ACP visits between transgender and other beneficiaries. <b><i>Results:</i></b> Beneficiaries identified as transgender were slightly more likely than those who were dual eligible for Medicaid and Medicare, and the remaining fee-for-service Medicare population, to have received a claim for ACP. However, racial and ethnic differences exist and transgender beneficiaries were more likely to receive an ACP claim from hospice/palliative care clinicians compared with primary care clinicians relative to other beneficiaries. <b><i>Conclusions:</i></b> Differences in ACP provision may exacerbate disparities in access to ACP benefits faced by transgender patients.