Advance Care Planning
Discussion and documentation of patient's goals, values, and preferences for future medical care; billable under CPT 99497 and 99498.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Billing
- Primary sources
- 1
- Workspace handoff
- ask d3 →
Where this comes up
This shows up in revenue-cycle work — claim scrubbing, charge entry, posting, A/R follow-up, and month-end close. Billers and practice managers hit this term when reconciling a payment, working a denial queue, or auditing why a claim aged past 60 days.
Full definition
What it is in practice
CMS ACP covers 99497 (first 30 minutes) and 99498 (additional 30 minutes). Can be furnished as part of an AWV or as a stand-alone service.
How it shows up in your practice
Document the discussion, the goals, and any advance directives created. Pair with AWV (modifier 33) for waived cost-sharing.
Sources
- CMS — Chronic Care Managementhttps://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/chroniccaremanagement.pdf
Confirm ACP billing in Ask D3
Open ask d3 →Related terms
- BillingAnnual Wellness Visit (AWV)A Medicare-covered preventive visit (G0438 initial, G0439 subsequent) focused on personalized prevention plans.
- PayerHospiceMedicare-covered comprehensive end-of-life care for beneficiaries with a life expectancy of 6 months or less, paid under the Hospice Payment System.
- BillingTransitional Care Management (TCM)Care management following discharge from an inpatient, partial-hospital, or observation stay; CPT 99495 (moderate complexity) and 99496 (high complexity).
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Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryTransitional Care Management (TCM)Care management following discharge from an inpatient, partial-hospital, or observation stay; CPT 99495 (moderate complexity) and 99496 (high complexity).
- GlossaryAnnual Wellness Visit (AWV)A Medicare-covered preventive visit (G0438 initial, G0439 subsequent) focused on personalized prevention plans.
- GlossaryHospiceMedicare-covered comprehensive end-of-life care for beneficiaries with a life expectancy of 6 months or less, paid under the Hospice Payment System.
- GlossaryChronic Care Management (CCM)Care management services for Medicare beneficiaries with two or more chronic conditions; billed monthly under CPT 99490 and related codes.
- GlossaryCollaborative Care Model (CoCM)Integrated primary-care behavioral-health model billable under CPT 99492-99494 and HCPCS G2214.
- GlossaryPrincipal Care Management (PCM)Care management for Medicare beneficiaries with a single high-risk chronic condition; billed under CPT 99424-99427.
- GlossaryMedication ReconciliationThe process of creating an accurate list of all medications a patient is taking and comparing it against new orders to identify discrepancies.
- BillingAWV + Problem Visit Same Day: How to Bill CorrectlyYes, you can bill AWV and a problem visit the same day. Here's how to do it correctly with modifier -25.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.