go back

Advance Care Planning Discussion

New Mexico 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 $93 · 10th–90th $65$1820%10%10th90th$93Professionalmedian $78 · 10th–90th $60$1450%20%10th90th$78$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
$70.79
Median
$107.15
Typical High
$158.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$72.44
Typical High
$144.54
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$67.61
Median
$87.10
Typical High
$281.84
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$72.44
Typical High
$85.11
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$54.95
Median
$72.44
Typical High
$85.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$288.40
Typical High
$478.63
BCBS
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$77.62
Typical High
$102.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$95.50
Typical High
$141.25
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$128.82
Providence
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$87.10
Typical High
$154.88
Providence
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$112.20
Typical High
$204.17
United
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$123.03
Typical High
$446.68
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$112.20
Typical High
$165.96
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$100.00
Median
$100.00
Typical High
$134.90