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Advance Care Planning Discussion

Maine 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 $91 · 10th–90th $72$910%50%10th$91Professionalmedian $89 · 10th–90th $63$1910%10%10th90th$89$50.0$200.0$1.0K$5.0K

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
Facility
Modifier
Global
Typical Low
$72.44
Median
$91.20
Typical High
$91.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$74.13
Typical High
$112.20
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$93.33
Typical High
$162.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$107.15
Typical High
$186.21
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$125.89
Typical High
$213.80
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$91.20
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$77.62
Typical High
$144.54
Martin's Point
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$117.49
Typical High
$186.21
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$100.00
Median
$100.00
Typical High
$100.00