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99497 Advncd care plan 30 minutes

Evaluation & Management

Also known as: advance care planning, end-of-life counseling

Advanced care plan development and counseling service for patient with serious illness (terminal condition, progressive neurological disease) for first 30 minutes.

In Plain Language

discussion about your wishes if you become seriously ill

Clinical Context

Used when physician conducts comprehensive discussion with patient regarding advance directives, goals of care, and end-of-life preferences.

RVU Breakdown

Work RVU1.50
Total RVU1.50

Est. Medicare Payment

$50.10

National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).

Billing & Documentation

E&M codes require documentation of medical decision-making (MDM) complexity or total time spent on the encounter. For 2026, time-based coding includes all physician time on the date of the encounter.

How This Code Compares

With a work RVU of 1.50, this code ranks in the 50th percentile among Evaluation & Management codes — 1.0x below the median (1.54). The highest wRVU in this category is 18.46.

Specialties

Palliative CareInternal MedicineFamily Medicine

Frequently Asked Questions

What is CPT code 99497?

CPT 99497 (Advncd care plan 30 minutes) is a Evaluation & Management code. Advanced care plan development and counseling service for patient with serious illness (terminal condition, progressive neurological disease) for first 30 minutes.

Who uses CPT code 99497?

CPT 99497 is used by Palliative Care, Internal Medicine, Family Medicine. Used when physician conducts comprehensive discussion with patient regarding advance directives, goals of care, and end-of-life preferences.

When is CPT 99497 used?

Used when physician conducts comprehensive discussion with patient regarding advance directives, goals of care, and end-of-life preferences.

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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.