go back

Advance Care Planning Discussion

Georgia 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 $68 · 10th–90th $62$1290%20%10th90th$68Professionalmedian $79 · 10th–90th $62$1660%10%10th90th$79$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$67.61
Typical High
$128.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$74.13
Typical High
$165.96
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$67.61
Median
$85.11
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$83.18
Typical High
$128.82
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$83.18
Typical High
$138.04
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$95.50
Typical High
$144.54
CareSource
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$93.33
Typical High
$102.33
CareSource
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$97.72
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$107.15
Typical High
$181.97
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$97.72
Typical High
$165.96
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$120.23
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$89.13
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$93.33
Typical High
$151.36
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$95.50
Typical High
$100.00