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Advance Care Planning Discussion

Kentucky 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 $76 · 10th–90th $59$1000%20%10th90th$76Professionalmedian $71 · 10th–90th $58$1380%20%10th90th$71$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
$58.88
Median
$63.10
Typical High
$70.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$72.44
Typical High
$138.04
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$87.10
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$72.44
Typical High
$91.20
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$54.95
Median
$70.79
Typical High
$91.20
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$63.10
Typical High
$77.62
CareSource
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$79.43
Typical High
$104.71
CareSource
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$114.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$100.00
Typical High
$416.87
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$112.20
United
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$123.03
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$87.10
Typical High
$138.04
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$100.00
Median
$100.00
Typical High
$100.00