End of life conseling

Can you bill for End of Life counseling if patient not present and is so, how would that be done?

end of life counseling

If it is a Medicare patient, no. If you search for "family meetings" you'll find a long discussion of the fact.

If the patient is critically ill, and the family member is the decision maker, AND the MD is still providing critical interventions, it could be part of the critical care time. Once the MD stops the interventions, you can't bill anymore for family meetings/end of life counseling without the patient.