Advance Care Planning (ACP) Coverage and Payment

CMS established 2 codes for ACP - one for the first 30 minutes of ACP (CPT - 99497) that will be paid at a national level of $86.00 and the second (CPT - 99498) for the next 30 minutes during the same ACP service will be paid at $75.00.

• CPT code 99497: Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health professional; first 30 minutes, face-to-face with the patient, family member(s) and/or surrogate
• CPT code 99498: Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health professional; each additional 30 minutes