go back

Advance Care Planning Discussion

Tennessee 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 $59$4790%10%10th90th$81Professionalmedian $76 · 10th–90th $60$1660%10%20%10th90th$76$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
$144.54
Median
$144.54
Typical High
$144.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$72.44
Typical High
$162.18
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$79.43
Typical High
$165.96
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$79.43
Typical High
$120.23
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$54.95
Median
$70.79
Typical High
$138.04
BCBS
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$107.15
Typical High
$169.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$95.50
Typical High
$158.49
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$478.63
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$524.81
United
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$75.86
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$89.13
Typical High
$144.54
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$95.50
Typical High
$100.00