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Advance Care Planning Discussion

Michigan 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 $81 · 10th–90th $71$980%20%10th90th$81Professionalmedian $78 · 10th–90th $60$1290%20%10th90th$78$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
$77.62
Median
$77.62
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$77.62
Typical High
$123.03
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$63.10
Median
$77.62
Typical High
$194.98
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$74.13
Typical High
$138.04
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$56.23
Median
$72.44
Typical High
$128.82
BCBS
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$81.28
BCBS
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$77.62
Typical High
$102.33
CareSource
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$91.20
Typical High
$100.00
CareSource
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$104.71
Typical High
$109.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$89.13
Typical High
$208.93
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$12.30
Median
$32.36
Typical High
$87.10
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$77.62
Typical High
$138.04
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$177.83
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$93.33
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$93.33
Typical High
$165.96
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$95.50
Median
$95.50
Typical High
$100.00