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Advance Care Planning Discussion

Massachusetts 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 $36$1120%10%20%10th90th$76Professionalmedian $100 · 10th–90th $63$2190%5%10%10th90th$100$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
$36.31
Median
$75.86
Typical High
$83.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$75.86
Typical High
$204.17
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$114.82
Typical High
$269.15
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$79.43
Typical High
$478.63
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$104.71
Typical High
$218.78
BCBS
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$194.98
BCBS
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$147.91
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$109.65
Typical High
$194.98
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$58.88
Typical High
$104.71
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$75.86
Typical High
$141.25
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$131.83
Typical High
$218.78
Health New England
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$125.89
Typical High
$154.88
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$79.43
Typical High
$478.63
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$104.71
Typical High
$218.78
Tufts
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$83.18
Typical High
$158.49
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$141.25
Typical High
$181.97
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$114.82
Typical High
$229.09
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$83.18
Median
$83.18
Typical High
$100.00