Part of Annual Wellness Visit
CPT 99498: Advance Care Planning, each additional 30 minutes
Add-on code for each additional 30 minutes of advance care planning discussion beyond the 99497 threshold.
Time threshold & code combinations
Each additional 30 minutes of face-to-face discussion, beyond 99497, same encounter.
- Cannot be billed without 99497 in the same encounter
Who can bill
- Physicians
- Non-physician practitioners who can bill E/M services
Eligibility & billing requirements
- Same eligibility as 99497
- 99497 must be billed first for the same encounter
- Only reported after the first 30-minute threshold (99497) has been met
When to use it
Extended family discussion
After the first 30 minutes, the conversation continues for another 30 minutes with family members present to finalize healthcare proxy paperwork.
Billing: 99497 + 99498
Documentation checklist
- Time log showing the additional 30-minute increment
Common billing mistakes
- Billing 99498 without a qualifying 99497 in the same encounter