Last updated: October 2026CMS rates · Free lookup

Medicare Fee Schedule Lookup

Search 2026 Medicare reimbursement rates and national payment amounts by CPT, HCPCS, MS-DRG, or NDC code. The lookup includes the Physician Fee Schedule, Drug ASP, MS-DRG weights and national rates, anesthesia conversion factors, the Clinical Laboratory Fee Schedule, DMEPOS, ambulance, opioid treatment program, and Part D negotiated price data from CMS.

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99498

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Year

20262025

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Physician Fee Schedule·99498·National·2026, 2025

Current non-facility rate

$78.16▲0.0%

Facility: $63.46

Recent trend

Code description

Advncd Care Plan Addl 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 Each Additional 30 Minutes List Separately In Addition To Code For Primary Procedure

Code	Date	State	Non-Facility Fee	Facility Fee	Description
99498	10/2026	N/A	$78.16	$63.46	Advncd Care Plan Addl 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 Each Additional 30 Minutes List Separately In Addition To Code For Primary Procedure
99498	7/2026	N/A	$78.16	$63.46	Advncd Care Plan Addl 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 Each Additional 30 Minutes List Separately In Addition To Code For Primary Procedure
99498	4/2026	N/A	$78.16	$63.46	Advncd Care Plan Addl 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 Each Additional 30 Minutes List Separately In Addition To Code For Primary Procedure
99498	1/2026	N/A	$78.16	$63.46	Advncd Care Plan Addl 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 Each Additional 30 Minutes List Separately In Addition To Code For Primary Procedure
99498	10/2025	N/A	$68.90	$68.58	Advncd Care Plan Addl 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 Each Additional 30 Minutes List Separately In Addition To Code For Primary Procedure
99498	7/2025	N/A	$68.90	$68.58	Advncd Care Plan Addl 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 Each Additional 30 Minutes List Separately In Addition To Code For Primary Procedure
99498	4/2025	N/A	$68.90	$68.58	Advncd Care Plan Addl 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 Each Additional 30 Minutes List Separately In Addition To Code For Primary Procedure
99498	1/2025	N/A	$68.90	$68.58	Advncd Care Plan Addl 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 Each Additional 30 Minutes List Separately In Addition To Code For Primary Procedure

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Medicaid comparison

See what state Medicaid programs pay for the same codes

50 state Medicaid agencies publish their own physician fee schedule, and the rate for a single code can differ several times over between them. Rates for 20 common codes, including 99213, 99214, 99203 are free in every state that prices them, with no login.

17,674 codes and 974,327 published rates, taken from the files the state agencies publish themselves.

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$220.11

99496Transj 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

$298.60

99497Advncd 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

$86.84

Methodology

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.

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