CPT code 99498: Advance care planning, each additional 30 minutes2026 Medicare rate & RVUs in Fort Worth, TX

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 Fort Worth, TX, Medicare pays $77.79 for 99498 in the office and $63.30 when it’s performed in a hospital or facility.

$77.79Office (non-facility)
$63.30Hospital or facility
−0.5%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 Fort Worth, TX
  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 Fort Worth, TX 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. Fort Worth, TX pays $77.79. The RVUs are the same everywhere; the geographic indexes change the dollars.

99498 in Fort Worth, TX vs other payment areas
  1. Fort Worth, TX · this page$77.79
  2. Austin, TX · Texas$79.56+$1.77
  3. Beaumont, TX · Texas$75.39−$2.40
  4. Brazoria, TX · Texas$77.62−$0.17
  5. Dallas, TX · Texas$78.04+$0.25
  6. Galveston, TX · Texas$77.82+$0.03
  7. Houston, TX · Texas$79.46+$1.67

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

Every other payment area

99498 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$76.42$62.47
Los Angeles, CACalifornia$84.26$66.87
Washington, DC areaDistrict of Columbia$86.08$68.76
Miami, FLFlorida$83.92$68.62
Chicago, ILIllinois$82.52$67.75
Manhattan, NYNew York$87.51$70.43
AlaskaAlaska$102.03$86.38
AlabamaAlabama$73.30$60.45

99498 rates by state

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

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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 Fort Worth, TX 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

100

Locality
Fort Worth, TX
Physician work
1.009
Practice expense
0.986
Malpractice
0.871
Office calculation for 99498 in Fort Worth, TX
ComponentRVULocality factorAdjusted
Physician work1.40× 1.0091.4126
Practice expense0.85× 0.9860.8381
Malpractice0.09× 0.8710.0784
Total RVUs2.3291
Conversion factor× 33.4009

Office rate, Fort Worth, TX$77.79

Office: (1.4 × 1.009 + 0.85 × 0.986 + 0.09 × 0.871) × $33.4009 = $77.79

Facility: (1.4 × 1.009 + 0.41 × 0.986 + 0.09 × 0.871) × $33.4009 = $63.30

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 Fort Worth, TX

99498 · Office / nonfacility

$77.79

Effective 2026-10-01

The base rate is $8.75 higher than on 2025-10-01, moving from $69.04 to $77.79 (12.7%).

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

    $69.04changed to$77.79

    • 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
    • Work GPCI 1.011 changed to 1.009
    • Practice expense GPCI 0.998 changed to 0.986
    • Malpractice GPCI 0.902 changed to 0.871

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $71.05changed to$69.04

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $69.89changed to$71.05

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $71.43changed to$69.89

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.62 changed to 0.63
    • Work GPCI 1.013 changed to 1.011
    • Practice expense GPCI 0.996 changed to 0.998
    • Malpractice GPCI 0.721 changed to 0.902
  5. January 1, 2023

    RVU23A

    $73.28changed to$71.43

    • 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 1.016 changed to 1.013
    • Practice expense GPCI 0.995 changed to 0.996
    • Malpractice GPCI 0.539 changed to 0.721

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $73.54changed to$73.28

    • 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

    $75.34changed to$73.54

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.62 changed to 0.64
    • Work GPCI 1.011 changed to 1.016
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.643 changed to 0.539

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $75.26changed to$75.34

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.007 changed to 1.011
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.747 changed to 0.643

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $75.18changed to$75.26

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $71.93changed to$75.18

    • 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 1.006 changed to 1.007
    • Practice expense GPCI 0.991 changed to 0.986
    • Malpractice GPCI 0.760 changed to 0.747

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $74.16changed to$71.93

    • 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 1.005 changed to 1.006
    • Practice expense GPCI 0.995 changed to 0.991
    • Malpractice GPCI 0.772 changed to 0.760

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$74.16

    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$77.79$63.30RVU26D
2026-07-01$77.79$63.30RVU26C
2026-04-01$77.79$63.30RVU26B
2026-01-01$77.79$63.30RVU26A
2025-10-01$69.04$68.72RVU25D
2025-07-01$69.04$68.72RVU25C
2025-04-01$69.04$68.72RVU25B
2025-01-01$69.04$68.72RVU25A
2024-10-01$71.05$70.38RVU24D
2024-07-01$71.05$70.38RVU24C
2024-04-01$71.05$70.38RVU24B
2024-03-09$71.05$70.38RVU24AR
2024-01-01$69.89$69.23RVU24A
2023-10-01$71.43$71.09RVU23D
2023-07-01$71.43$71.09RVU23C
2023-04-01$71.43$71.09RVU23B
2023-01-01$71.43$71.09RVU23A
2022-10-01$73.28$72.60RVU22D
2022-07-01$73.28$72.60RVU22C
2022-04-01$73.28$72.60RVU22B
2022-01-01$73.28$72.60RVU22A
2021-10-01$73.54$73.20RVU21D
2021-07-01$73.54$73.20RVU21C
2021-04-01$73.54$73.20RVU21B
2021-01-01$73.54$73.20RVU21A
2020-10-01$75.34$74.99RVU20D
2020-07-01$75.34$74.99RVU20C
2020-04-01$75.34$74.99RVU20B
2020-01-01$75.34$74.99RVU20A
2019-10-01$75.26$74.91RVU19D
2019-07-01$75.26$74.91RVU19C
2019-04-01$75.26$74.91RVU19B
2019-01-01$75.26$74.91RVU19A
2018-10-01$75.18$74.82RVU18D
2018-07-01$75.18$74.82RVU18C
2018-04-01$75.18$74.82RVU18B
2018-01-01$75.18$74.82RVU18AR1
2017-10-01$71.93$71.93RVU17D
2017-07-01$71.93$71.93RVU17C
2017-04-01$71.93$71.93RVU17B
2017-01-01$71.93$71.93RVU17A
2016-10-01$74.16$73.80RVU16D
2016-07-01$74.16$73.80RVU16C
2016-04-01$74.16$73.80RVU16B
2016-01-01$74.16$73.80RVU16A
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 Fort Worth, TX rate applies

Fort Worth, TX is a Medicare payment area, not a city. Our Census mapping connects it to 45 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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 Fort Worth, TXGPCI2026.csv, line 100 (RVU26D)

Open CMS sourceHow we calculate rates

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