Mar 20, 2022 - 10mins Read

How to document and bill for Advance Care Planning – 99497

Author
Sneha Moorjani
Published On
September 9, 2025
Category
Advance Care Planning

Since 2016, Medicare has paid for Advance Care Planning services. The number of providers billing for the service has steadily increased since then and Medicare Advantage plans are encouraging providers to have a discussion with their patients regarding their end of life plan.

Advance Care Planning consists of the following two codes:

99497 (~$86*)  “Advance Care Planning including the explanation and discussion of advance directives such as standard forms (including the completion of such forms, when performed), by the physician or other qualified health professional; first 30 minutes, face-to-face with the patient, family members, and/or surrogate.”

99498 (~$85*) – Add-on code each additional 30 mins.

*National average medicare reimbursement in 2020. Check with your billers or local MAC for exact reimbursement.

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How to document and bill for Advance Care Planning – 99497