CPT 99497: Advance Care Planning - First 30 min
Advance care planning including the explanation and discussion of advance directives by the physician or other qualified health care professional, first 30 minutes face-to-face with the patient, family member(s), and/or surrogate.
Documentation Requirements
- Discussion of advance directives (living will, healthcare proxy)
- Patient (and/or surrogate/family) participation documented
- Topics discussed (resuscitation, intubation, artificial nutrition, etc.)
- Patient preferences and values documented
- Time spent in face-to-face discussion
- Outcome of discussion (documents completed, deferred, etc.)
Billing Tips
- Time-based: first 30 minutes = 99497; additional 30 minutes = 99498
- Can be billed with E&M on same date with modifier 25
- No diagnosis code restriction — can use Z71.89 or underlying condition
- Medicare covers as part of AWV without cost-sharing
- Document who participated in the discussion
- Not limited to end-of-life — appropriate for any serious illness
Frequently Asked Questions
What must be documented for advance care planning?
Document the discussion topics (CPR, intubation, nutrition), participants, patient preferences, time spent, and outcome. Scribeable captures these conversations and generates structured ACP documentation.
How does Scribeable help with advance care planning notes?
Scribeable captures the sensitive ACP conversation in real time and generates comprehensive notes documenting patient values, preferences, discussion topics, and outcomes — supporting compliant 99497 billing.