How to document and bill for Advance Care Planning – 99497

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.

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