CPT code 99498: Advance care planning, each additional 30 minutes2026 Medicare rate & RVUs in Chicago, IL

Reports each additional 30 minutes of face-to-face advance care planning beyond the initial service, such as discussion of a patient's goals and future care preferences.

CMS RVU26DEffective Oct 1, 2026One payment locality91.2K Medicare services in 2024

In Chicago, IL, Medicare pays $82.52 for 99498 in the office and $67.75 when it’s performed in a hospital or facility.

$82.52Office (non-facility)
$67.75Hospital or facility
+5.6%vs the national office rate ($78.16)

Check a contract rate as a % of Medicare · 99498 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 99498 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Chicago, IL
  2. What 99498 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 99498 covers

This add-on represents additional face-to-face time spent discussing a patient's goals, values, and preferences for future medical care, including choices about life-sustaining treatment and advance directives. Physicians and other qualified health care professionals may furnish the discussion with the patient and, when appropriate, family members or a surrogate. These conversations commonly occur in an office or facility when a patient is considering or documenting preferences for care if they cannot make decisions later.

Report 99498 with 99497 when the documented advance care planning discussion extends beyond the initial service and supports another 30-minute unit. The record should identify the participants, topics discussed, and time spent in the face-to-face discussion. This is an add-on code: CMS requires it to be billed with a primary procedure, and payment falls within that procedure's global period. Do not use it for time spent on routine counseling or other care-management activities rather than advance care planning.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Chicago, IL compares for 99498

Across 109 of 109 payment localities, the office rate for 99498 runs from $72.70 in Arkansas to $102.03 in Alaska. Chicago, IL pays $82.52. The RVUs are the same everywhere; the geographic indexes change the dollars.

99498 in Chicago, IL vs other payment areas
  1. Chicago, IL · this page$82.52
  2. East St. Louis, IL · Illinois$78.94−$3.58
  3. Rest of Illinois · Illinois$77.38−$5.14
  4. Suburban Chicago, IL · Illinois$81.57−$0.95
  5. Los Angeles, CA · California$84.26+$1.74
  6. Washington, DC area · District of Columbia$86.08+$3.56
  7. Miami, FL · Florida$83.92+$1.40

Other areas in Illinois first, then benchmark localities. Bars start at $0.

Every other payment area

99498 in every other Medicare payment locality
Payment localityOfficeFacility
Manhattan, NYNew York$87.51$70.43
AlaskaAlaska$102.03$86.38
AlabamaAlabama$73.30$60.45
ArkansasArkansas$72.70$60.07
ArizonaArizona$76.85$62.60
Bakersfield, CACalifornia$80.60$64.49
Chico, CACalifornia$80.28$64.18
El Centro, CACalifornia$80.30$64.19

99498 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$72.70

$102.03

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
99498 office rate range by state
State / territoryOffice rate rangeLocalities
AK$102.031
AL$73.301
AR$72.701
AZ$76.851
CA$80.28–$94.4629
CO$79.881
CT$81.911
DC$86.081
DE$77.751
FL$78.42–$83.923
GA$75.67–$79.362
GU$80.781
HI$80.781
IA$73.931
ID$74.301
IL$77.38–$82.524
IN$74.541
KS$73.941
KY$74.751
LA$74.77–$76.892
MA$79.80–$85.252
MD$78.72–$86.083
ME$74.75–$76.792
MI$76.08–$79.232
MN$76.871
MO$74.16–$76.803
MS$73.431
MT$78.151
NC$75.171
ND$76.371
NE$74.101
NH$78.951
NJ$82.93–$85.852
NM$76.411
NV$77.681
NY$75.85–$89.095
OH$75.711
OK$74.451
OR$77.15–$81.292
PA$75.66–$80.742
PR$78.431
RI$79.661
SC$75.551
SD$76.161
TN$74.181
TX$75.39–$79.568
UT$76.151
VA$76.79–$86.082
VI$78.431
VT$76.391
WA$79.55–$86.392
WI$74.891
WV$75.731
WY$77.381

See 99498 in every payment locality

How the 99498 rate is calculated

Each of 99498’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 99498

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.40

1.40 RVUs× 1.000 GPCI

Practice expense0.85

0.85 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

2.3400

Conversion factor

$33.4009

Medicare rate

$78.16

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Chicago, IL inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,162

Code
99498
Physician work
1.40
Practice expense
0.85
Malpractice
0.09

GPCI2026.csv

48

Locality
Chicago, IL
Physician work
1.007
Practice expense
1.005
Malpractice
2.295
Office calculation for 99498 in Chicago, IL
ComponentRVULocality factorAdjusted
Physician work1.40× 1.0071.4098
Practice expense0.85× 1.0050.8542
Malpractice0.09× 2.2950.2065
Total RVUs2.4706
Conversion factor× 33.4009

Office rate, Chicago, IL$82.52

Office: (1.4 × 1.007 + 0.85 × 1.005 + 0.09 × 2.295) × $33.4009 = $82.52

Facility: (1.4 × 1.007 + 0.41 × 1.005 + 0.09 × 2.295) × $33.4009 = $67.75

Open 99498 in the RVU calculator

Payment rules and modifiers for 99498

The CMS indicators that decide how 99498 is paid alongside other services.

CMS payment indicators · 99498

Advance care planning, each additional 30 minutes

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

How 99498 has changed in Chicago, IL

99498 · Office / nonfacility

$82.52

Effective 2026-10-01

The base rate is $9.54 higher than on 2025-10-01, moving from $72.98 to $82.52 (13.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $72.98changed to$82.52

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.63 changed to 0.85
    • Malpractice RVU 0.10 changed to 0.09
    • Practice expense GPCI 1.023 changed to 1.005
    • Malpractice GPCI 2.018 changed to 2.295

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $75.10changed to$72.98

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $73.87changed to$75.10

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $76.16changed to$73.87

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.62 changed to 0.63
    • Work GPCI 1.009 changed to 1.007
    • Practice expense GPCI 1.033 changed to 1.023
    • Malpractice GPCI 1.945 changed to 2.018
  5. January 1, 2023

    RVU23A

    $78.29changed to$76.16

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.65 changed to 0.62
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.011 changed to 1.009
    • Practice expense GPCI 1.044 changed to 1.033
    • Malpractice GPCI 1.871 changed to 1.945

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $78.58changed to$78.29

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.64 changed to 0.65

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $80.39changed to$78.58

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.62 changed to 0.64
    • Work GPCI 1.009 changed to 1.011
    • Practice expense GPCI 1.039 changed to 1.044
    • Malpractice GPCI 1.898 changed to 1.871

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $80.21changed to$80.39

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.008 changed to 1.009
    • Practice expense GPCI 1.034 changed to 1.039
    • Malpractice GPCI 1.925 changed to 1.898

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $80.12changed to$80.21

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $76.59changed to$80.12

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.54 changed to 0.62
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.012 changed to 1.008
    • Practice expense GPCI 1.036 changed to 1.034
    • Malpractice GPCI 1.972 changed to 1.925

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $80.06changed to$76.59

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.59 changed to 0.54
    • Malpractice RVU 0.10 changed to 0.08
    • Work GPCI 1.016 changed to 1.012
    • Practice expense GPCI 1.037 changed to 1.036
    • Malpractice GPCI 2.019 changed to 1.972

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$80.06

    Held through RVU16B, RVU16C, RVU16D.

  13. January 1, 2015

    RVU15A

    No ratechanged toNo rate

    Held through RVU15B, RVU15C, RVU15D.

  14. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$82.52$67.75RVU26D
2026-07-01$82.52$67.75RVU26C
2026-04-01$82.52$67.75RVU26B
2026-01-01$82.52$67.75RVU26A
2025-10-01$72.98$72.65RVU25D
2025-07-01$72.98$72.65RVU25C
2025-04-01$72.98$72.65RVU25B
2025-01-01$72.98$72.65RVU25A
2024-10-01$75.10$74.42RVU24D
2024-07-01$75.10$74.42RVU24C
2024-04-01$75.10$74.42RVU24B
2024-03-09$75.10$74.42RVU24AR
2024-01-01$73.87$73.20RVU24A
2023-10-01$76.16$75.81RVU23D
2023-07-01$76.16$75.81RVU23C
2023-04-01$76.16$75.81RVU23B
2023-01-01$76.16$75.81RVU23A
2022-10-01$78.29$77.57RVU22D
2022-07-01$78.29$77.57RVU22C
2022-04-01$78.29$77.57RVU22B
2022-01-01$78.29$77.57RVU22A
2021-10-01$78.58$78.21RVU21D
2021-07-01$78.58$78.21RVU21C
2021-04-01$78.58$78.21RVU21B
2021-01-01$78.58$78.21RVU21A
2020-10-01$80.39$80.02RVU20D
2020-07-01$80.39$80.02RVU20C
2020-04-01$80.39$80.02RVU20B
2020-01-01$80.39$80.02RVU20A
2019-10-01$80.21$79.83RVU19D
2019-07-01$80.21$79.83RVU19C
2019-04-01$80.21$79.83RVU19B
2019-01-01$80.21$79.83RVU19A
2018-10-01$80.12$79.75RVU18D
2018-07-01$80.12$79.75RVU18C
2018-04-01$80.12$79.75RVU18B
2018-01-01$80.12$79.75RVU18AR1
2017-10-01$76.59$76.59RVU17D
2017-07-01$76.59$76.59RVU17C
2017-04-01$76.59$76.59RVU17B
2017-01-01$76.59$76.59RVU17A
2016-10-01$80.06$79.69RVU16D
2016-07-01$80.06$79.69RVU16C
2016-04-01$80.06$79.69RVU16B
2016-01-01$80.06$79.69RVU16A
2015-10-01Separate payment rules applySeparate payment rules applyRVU15D
2015-07-01Separate payment rules applySeparate payment rules applyRVU15C
2015-04-01Separate payment rules applySeparate payment rules applyRVU15B
2015-01-01Separate payment rules applySeparate payment rules applyRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 99498 for an earlier date of service

Where the Chicago, IL rate applies

Chicago, IL is a Medicare payment area, not a city. Our Census mapping connects it to 137 cities and communities in Illinois. Some span more than one payment area; confirm with the service ZIP.

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99498 billing questions

Can 99498 be reported by itself?

No. It is an add-on and is reported with the primary advance care planning service, 99497.

When should the record support an additional unit?

Document the additional face-to-face advance care planning time, the participants, and the subjects discussed. The extra time must represent advance care planning, not unrelated counseling or care management.

Does 99498 represent the initial advance care planning discussion?

No. 99497 represents the initial service; 99498 reports each additional 30-minute unit.

Can an office E/M service be reported on the same date?

A separately identifiable E/M service may be reported for a distinct evaluation and management service on that date. Document the E/M work separately from the advance care planning discussion.

What distinguishes advance care planning from routine care management?

99498 is for additional time discussing a patient's future-care preferences, goals, or advance directives. Time coordinating ongoing chronic-condition care is not advance care planning time.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 99498PPRRVU2026_Oct_nonQPP.csv, line 13,162 (RVU26D)
Geographic factors for Chicago, ILGPCI2026.csv, line 48 (RVU26D)

Open CMS sourceHow we calculate rates

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