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Advance Care Planning Discussion

Wisconsin 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 $79 · 10th–90th $62$1740%10%10th90th$79Professionalmedian $100 · 10th–90th $62$2570%10%10th90th$100$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
$64.57
Median
$70.79
Typical High
$213.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$70.79
Typical High
$204.17
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$79.43
Typical High
$346.74
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$114.82
Typical High
$208.93
CareSource
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$85.11
Typical High
$97.72
CareSource
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$97.72
Typical High
$117.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$251.19
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$162.18
Typical High
$234.42
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$77.62
Typical High
$154.88
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$165.96
Typical High
$218.78
Medica
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$165.96
Medica
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$147.91
Typical High
$524.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$70.79
Network Health
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$114.82
Typical High
$204.17
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$77.62
Typical High
$154.88
Quartz
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$165.96
Typical High
$245.47
Quartz
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$478.63
Quartz
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$177.83
Typical High
$524.81
Security Health
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$100.00
Security Health
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$138.04
Typical High
$169.82
United
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$107.15
United
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$165.96
Typical High
$257.04
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$100.00
Median
$100.00
Typical High
$100.00