CPT Codes 99497 and 99498 are codes that describe complex Advance Care Planning. These codes are time based codes that include the following:

  • Face-to-face between physician or qualified health provider, patient or surrogate in counseling and discussion advance directives.
  • Counseling and discussion of advanced directives
  • With or without completion of relevant legal forms

An advanced directive is a legally-binding document that either appoints a trusted person to act as a patient’s agent if the patient is unable to speak for herself and/or records the wishes of a patient pertaining to her future medical treatment should she lack decisional capability at that time.

An Evaluation and Management service may be reported separately on the same day except for critical care services, inpatient neonatal and pediatric critical care services, and initial and continuing intensive care services.

Assigning and Billing Advanced Care Planning Services

Currently the codes are not reimbursed by Medicare.

Author - Female

About the author

Stephanie Johnson, CHC, RHIT, CPC, CPEDS is Compliance Manager – Academic, Office-based and Multi-specialty Physicians of McKesson Business Performance Services.