Care Mgmt / Counsel · CMS status A

99498

Advncd care plan addl 30 min

Advance care planning, each additional 30 minutes beyond the first 30 minutes billed under 99497. CMS 2026 wRVU 1.40, paid using the national GPCI and the 2026 conversion factor of $33.4009. Add-on only; it can never appear on a claim without 99497.

Work RVU
1.40
2026 Medicare pays
$78.16
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 1.40 + Practice 0.85 + Malpractice 0.09 = 2.34 total
Work (your effort)Practice expenseMalpractice
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Common modifiers
33 (when billed with an AWV on the same day to waive Medicare cost share)
Common ICD-10 pairings
Z71.89Z51.5Z66

Payer notes

Medicare covers ACP with no frequency limit when medically necessary, but repeat long ACP sessions should document the change in condition or goals that warranted revisiting the plan. Cost share applies except when ACP accompanies an AWV with modifier 33. Medicare Advantage follows Medicare. Commercial coverage is common but inconsistent on the add-on specifically; some plans cap recognized units of 99498 per date of service. The wRVU on a fully captured 76-minute ACP encounter (99497 + 2 x 99498) is 4.30, which exceeds a 99215, making accurate time capture worthwhile for clinicians doing serious-illness care.

Pairs well with

Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.