Last updated: July 2026CMS rates · Free lookup
Medicare Fee Schedule Lookup
Search 2026 Medicare reimbursement rates and national payment amounts by CPT, HCPCS, or MS-DRG code. The lookup includes the Physician Fee Schedule, Drug ASP, MS-DRG weights, anesthesia conversion factors, and Clinical Laboratory Fee Schedule data from CMS.
Available data
Filters
99497
20252026
Select one or more years
Up to 5 codes · 4 remaining
Need commercial rates?
Compare Medicare against in-network rates from 180+ payers.
Run a free sample reportShowing
Physician Fee Schedule·99497·National·2025, 2026
Current non-facility rate
$86.84▲0.0%
Facility: $65.80
Recent trend
Code description
Advncd Care Plan 30 Min, 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 Care Professional First 30 Minutes Face To Face With The Patient Family Member S And Or Surrogate
| Code | Date | State | Locality | Carrier | Non-Facility Fee | Facility Fee | Description |
|---|---|---|---|---|---|---|---|
| 99497 | 7/2026 | N/A | 00 | 00000 | $86.84 | $65.80 | Advncd Care Plan 30 Min, 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 Care Professional First 30 Minutes Face To Face With The Patient Family Member S And Or Surrogate |
| 99497 | 4/2026 | N/A | 00 | 00000 | $86.84 | $65.80 | Advncd Care Plan 30 Min, 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 Care Professional First 30 Minutes Face To Face With The Patient Family Member S And Or Surrogate |
| 99497 | 1/2026 | N/A | 00 | 00000 | $86.84 | $65.80 | Advncd Care Plan 30 Min, 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 Care Professional First 30 Minutes Face To Face With The Patient Family Member S And Or Surrogate |
| 99497 | 10/2025 | N/A | 00 | 00000 | $79.57 | $72.46 | Advncd Care Plan 30 Min, 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 Care Professional First 30 Minutes Face To Face With The Patient Family Member S And Or Surrogate |
| 99497 | 7/2025 | N/A | 00 | 00000 | $79.57 | $72.46 | Advncd Care Plan 30 Min, 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 Care Professional First 30 Minutes Face To Face With The Patient Family Member S And Or Surrogate |
| 99497 | 4/2025 | N/A | 00 | 00000 | $79.57 | $72.46 | Advncd Care Plan 30 Min, 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 Care Professional First 30 Minutes Face To Face With The Patient Family Member S And Or Surrogate |
| 99497 | 1/2025 | N/A | 00 | 00000 | $79.57 | $72.46 | Advncd Care Plan 30 Min, 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 Care Professional First 30 Minutes Face To Face With The Patient Family Member S And Or Surrogate |
PayerPrice Platform
Compare Medicare rates with published commercial rates for the same code
Search negotiated rates from more than 180 commercial payers by NPI, TIN, and ZIP code. Review historical rates or export the data through API, SQL, MCP, or bulk download.
Related codes
99350Home Res Vst Est High Mdm 60, Home Or Residence Visit For The Evaluation And Management Of An Established Patient Which Requires A Medically Appropriate History And Or Examination And High Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 60 Minutes Must Be Met Or Exceeded
$193.0699495Care Management, Assessment Of And Care Planning For A Patient With Cognitive Impairment Requiring An Independent Historian In The Office Or Other Outpatient Home Or Domiciliary Or Rest Home With All Of The Following Required Elements: Cognition-Focused Evaluation Including A Pertinent History And Examination Medical Decision Making Of Moderate Or High Complexity Functional Assessment (Eg Basic And Instrumental Activities Of Daily Living) Including Decision-Making Capacity Use Of Standardized
$220.1199496Transj Care Mgmt High F2f 7d, Transitional Care Management Services With The Following Required Elements Communication Direct Contact Telephone Electronic With The Patient And Or Caregiver Within 2 Business Days Of Discharge High Level Of Medical Decision Making During The Service Period Face To Face Visit Within 7 Calendar Days Of Discharge
$298.60Methodology
Rates are sourced directly from CMS Physician Fee Schedule files, indexed quarterly. Non-facility and facility prices are calculated using the published GPCI for each locality and the year's conversion factor.
View CMS Physician Fee Schedule