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Advance Care Planning Discussion

Washington, DC rates for HCPCS 99497

A face-to-face conversation between a clinician and a patient, a family member or a person appointed to decide on their behalf, about the patient's wishes for future medical care. It covers explaining and discussing advance directives such as a living will or naming a healthcare proxy, and completing those forms if the patient wishes. It covers the first substantial block of time spent on the discussion.

Rates data updated July 2026.

Facilitymedian $60 · 10th–90th $60$660%20%40%90th$60Professionalmedian $76 · 10th–90th $58$1070%10%20%10th90th$76$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$74.13
Typical High
$97.72
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$13.80
Median
$14.13
Typical High
$67.61
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$79.43
Cigna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$87.10
Typical High
$186.21
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$95.50
Typical High
$134.90
United
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$66.07
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$97.72
Typical High
$169.82
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$100.00
Median
$100.00
Typical High
$100.00