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Advance Care Planning Discussion

Rhode Island 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 $123 · 10th–90th $107$2040%20%10th90th$123Professionalmedian $83 · 10th–90th $36$1050%20%10th90th$83$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$123.03
Typical High
$169.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$83.18
Typical High
$97.72
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$16.60
Median
$77.62
Typical High
$95.50
BCBS
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$186.21
Typical High
$234.42
BCBS
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$10.00
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$109.65
Typical High
$177.83
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$91.20
Typical High
$147.91
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$100.00
Median
$100.00
Typical High
$100.00