CPT 99498

Advance Care Planning Ea Addl 30 Mins

CPT 99498 pays $78.16 in a non-facility setting and $63.46 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $72.70 in Arkansas to $102.03 in Alaska, a 40% spread.

National non-facility rate

$78.16

Office and other outpatient settings

Facility rate
$63.46

Hospital and ASC settings

Highest state
$102.03

Alaska

Lowest state
$72.70

Arkansas · 40% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $78.16
CPT 99498 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $78.16, national facility $63.46.
StateRate compared visuallyNon-facilityFacility
Alaska
$102.03$86.38
District of Columbia
$86.08$68.76
New York
$84.74$68.34
New Jersey
$84.39$67.84
California
$83.66$66.27
Washington
$82.97$66.22
Massachusetts
$82.53$66.02
Connecticut
$81.91$66.08
Florida
$81.10$66.35
Hawaii
$80.78$64.07
Maryland
$80.21$64.88
Illinois
$80.10$65.90
Colorado
$79.88$64.24
Rhode Island
$79.66$64.48
Oregon
$79.22$63.74
New Hampshire
$78.95$63.65
Puerto Rico
$78.43$63.57
Virgin Islands
$78.43$63.57
Pennsylvania
$78.20$63.81
Montana
$78.15$63.46
Texas
$77.76$63.29
Delaware
$77.75$63.23
Nevada
$77.68$62.97
Michigan
$77.65$63.85
Georgia
$77.51$63.49
Wyoming
$77.38$62.68
Minnesota
$76.87$61.74
Arizona
$76.85$62.60
Virginia
$76.79$62.35
New Mexico
$76.41$62.93
Vermont
$76.39$61.84
North Dakota
$76.37$61.68
South Dakota
$76.16$61.47
Utah
$76.15$62.33
Louisiana
$75.83$62.41
Maine
$75.77$61.73
Missouri
$75.77$62.29
West Virginia
$75.73$62.96
Ohio
$75.71$62.29
South Carolina
$75.55$61.97
North Carolina
$75.17$61.46
Wisconsin
$74.89$60.81
Kentucky
$74.75$61.69
Indiana
$74.54$60.92
Oklahoma
$74.45$61.33
Idaho
$74.30$60.78
Tennessee
$74.18$60.82
Nebraska
$74.10$60.54
Kansas
$73.94$60.66
Iowa
$73.93$60.49
Mississippi
$73.43$60.77
Alabama
$73.30$60.45
Arkansas
$72.70$60.07

Commercial rates for 99498

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates