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Advance Care Planning Discussion

Missouri 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 $59$1410%20%10th90th$91Professionalmedian $78 · 10th–90th $59$1820%20%10th90th$78$0.0$0.1$0.5$2.0$10.0$50.0$200.0

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
$100.00
Median
$128.82
Typical High
$138.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$74.13
Typical High
$154.88
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$67.61
Median
$95.50
Typical High
$288.40
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$77.62
Typical High
$100.00
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$64.57
Median
$72.44
Typical High
$131.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$79.43
Typical High
$131.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$85.11
Typical High
$117.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$100.00
Typical High
$162.18
Medica
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$79.43
Typical High
$151.36
Medica
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$107.15
Typical High
$524.81
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Qualchoice
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$100.00
Qualchoice
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$117.49
Median
$117.49
Typical High
$117.49
United
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$125.89
Typical High
$645.65
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$87.10
Typical High
$138.04
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$87.10
Median
$100.00
Typical High
$100.00