CPT code 99498: Advance care planning, each additional 30 minutes2026 Medicare rate & RVUs in Galveston, 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.
In Galveston, TX, Medicare pays $77.82 for 99498 in the office and $63.22 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Galveston, 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. Galveston, TX pays $77.82. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Galveston, TX · this page$77.82
- Austin, TX · Texas$79.56+$1.74
- Beaumont, TX · Texas$75.39−$2.43
- Brazoria, TX · Texas$77.62−$0.20
- Dallas, TX · Texas$78.04+$0.22
- Fort Worth, TX · Texas$77.79−$0.03
- Houston, TX · Texas$79.46+$1.64
Other areas in Texas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| 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 |
| Fresno, CACalifornia | $80.28 | $64.18 |
| Hanford, CACalifornia | $80.28 | $64.18 |
| Madera, CACalifornia | $80.28 | $64.18 |
| Merced, CACalifornia | $80.28 | $64.18 |
| Modesto, CACalifornia | $80.28 | $64.18 |
| Napa, CACalifornia | $88.65 | $69.28 |
| Oxnard, CACalifornia | $83.50 | $66.13 |
| Redding, CACalifornia | $80.28 | $64.18 |
| Rest of CaliforniaCalifornia | $80.28 | $64.18 |
| Riverside, CACalifornia | $81.28 | $65.18 |
| Sacramento, CACalifornia | $83.07 | $65.98 |
| Salinas, CACalifornia | $82.73 | $65.69 |
| San Diego, CACalifornia | $83.75 | $66.17 |
| Marin County, CACalifornia | $92.61 | $71.89 |
| San Francisco, CACalifornia | $92.51 | $71.79 |
| San Benito County, CACalifornia | $94.46 | $73.26 |
| Santa Clara County, CACalifornia | $94.04 | $72.85 |
| San Luis Obispo, CACalifornia | $81.50 | $64.77 |
| Santa Cruz, CACalifornia | $83.85 | $65.99 |
| Santa Maria, CACalifornia | $82.79 | $65.65 |
| Santa Rosa, CACalifornia | $84.64 | $66.59 |
| Stockton, CACalifornia | $80.28 | $64.18 |
| Vallejo, CACalifornia | $88.51 | $69.14 |
| Visalia, CACalifornia | $80.28 | $64.18 |
| Yuba City, CACalifornia | $80.28 | $64.18 |
| ColoradoColorado | $79.88 | $64.24 |
| ConnecticutConnecticut | $81.91 | $66.08 |
| DelawareDelaware | $77.75 | $63.23 |
| Fort Lauderdale, FLFlorida | $80.96 | $66.07 |
| Rest of FloridaFlorida | $78.42 | $64.37 |
| Atlanta, GAGeorgia | $79.36 | $64.43 |
| Rest of GeorgiaGeorgia | $75.67 | $62.56 |
| Hawaii, Guam, HIHawaii | $80.78 | $64.07 |
| IowaIowa | $73.93 | $60.49 |
| IdahoIdaho | $74.30 | $60.78 |
| East St. Louis, ILIllinois | $78.94 | $65.41 |
| Rest of IllinoisIllinois | $77.38 | $63.96 |
| Suburban Chicago, ILIllinois | $81.57 | $66.48 |
| IndianaIndiana | $74.54 | $60.92 |
| KansasKansas | $73.94 | $60.66 |
| KentuckyKentucky | $74.75 | $61.69 |
| New Orleans, LALouisiana | $76.89 | $63.06 |
| Rest of LouisianaLouisiana | $74.77 | $61.76 |
| Metropolitan Boston, MAMassachusetts | $85.25 | $67.70 |
| Rest of MassachusettsMassachusetts | $79.80 | $64.33 |
| Baltimore area, MDMaryland | $81.69 | $65.92 |
| Rest of MarylandMaryland | $78.72 | $63.85 |
| Rest of MaineMaine | $74.75 | $61.23 |
| Southern Maine, MEMaine | $76.79 | $62.23 |
| Detroit, MIMichigan | $79.23 | $65.04 |
| Rest of MichiganMichigan | $76.08 | $62.66 |
| MinnesotaMinnesota | $76.87 | $61.74 |
| Metropolitan Kansas City, MOMissouri | $76.36 | $62.56 |
| Metropolitan St. Louis, MOMissouri | $76.80 | $62.81 |
| Rest of MissouriMissouri | $74.16 | $61.49 |
| MississippiMississippi | $73.43 | $60.77 |
| MontanaMontana | $78.15 | $63.46 |
| North CarolinaNorth Carolina | $75.17 | $61.46 |
| North DakotaNorth Dakota | $76.37 | $61.68 |
| NebraskaNebraska | $74.10 | $60.54 |
| New HampshireNew Hampshire | $78.95 | $63.65 |
| Northern New JerseyNew Jersey | $85.85 | $68.80 |
| Rest of New JerseyNew Jersey | $82.93 | $66.88 |
| New MexicoNew Mexico | $76.41 | $62.93 |
| NevadaNevada | $77.68 | $62.97 |
| NYC suburbs and Long Island, NYNew York | $89.09 | $71.62 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $83.59 | $67.50 |
| Queens, NYNew York | $87.65 | $70.28 |
| Rest of New YorkNew York | $75.85 | $61.88 |
| OhioOhio | $75.71 | $62.29 |
| OklahomaOklahoma | $74.45 | $61.33 |
| Portland, OROregon | $81.29 | $64.96 |
| Rest of OregonOregon | $77.15 | $62.51 |
| Metropolitan Philadelphia, PAPennsylvania | $80.74 | $65.45 |
| Rest of PennsylvaniaPennsylvania | $75.66 | $62.17 |
| Puerto RicoPuerto Rico | $78.43 | $63.57 |
| Rhode IslandRhode Island | $79.66 | $64.48 |
| South CarolinaSouth Carolina | $75.55 | $61.97 |
| South DakotaSouth Dakota | $76.16 | $61.47 |
| TennesseeTennessee | $74.18 | $60.82 |
| UtahUtah | $76.15 | $62.33 |
| VirginiaVirginia | $76.79 | $62.35 |
| Virgin Islands, VIUnited States Virgin Islands | $78.43 | $63.57 |
| VermontVermont | $76.39 | $61.84 |
| Rest of WashingtonWashington | $79.55 | $64.08 |
| King County, WAWashington | $86.39 | $68.36 |
| WisconsinWisconsin | $74.89 | $60.81 |
| West VirginiaWest Virginia | $75.73 | $62.96 |
| WyomingWyoming | $77.38 | $62.68 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $102.03 | 1 |
| AL | $73.30 | 1 |
| AR | $72.70 | 1 |
| AZ | $76.85 | 1 |
| CA | $80.28–$94.46 | 29 |
| CO | $79.88 | 1 |
| CT | $81.91 | 1 |
| DC | $86.08 | 1 |
| DE | $77.75 | 1 |
| FL | $78.42–$83.92 | 3 |
| GA | $75.67–$79.36 | 2 |
| GU | $80.78 | 1 |
| HI | $80.78 | 1 |
| IA | $73.93 | 1 |
| ID | $74.30 | 1 |
| IL | $77.38–$82.52 | 4 |
| IN | $74.54 | 1 |
| KS | $73.94 | 1 |
| KY | $74.75 | 1 |
| LA | $74.77–$76.89 | 2 |
| MA | $79.80–$85.25 | 2 |
| MD | $78.72–$86.08 | 3 |
| ME | $74.75–$76.79 | 2 |
| MI | $76.08–$79.23 | 2 |
| MN | $76.87 | 1 |
| MO | $74.16–$76.80 | 3 |
| MS | $73.43 | 1 |
| MT | $78.15 | 1 |
| NC | $75.17 | 1 |
| ND | $76.37 | 1 |
| NE | $74.10 | 1 |
| NH | $78.95 | 1 |
| NJ | $82.93–$85.85 | 2 |
| NM | $76.41 | 1 |
| NV | $77.68 | 1 |
| NY | $75.85–$89.09 | 5 |
| OH | $75.71 | 1 |
| OK | $74.45 | 1 |
| OR | $77.15–$81.29 | 2 |
| PA | $75.66–$80.74 | 2 |
| PR | $78.43 | 1 |
| RI | $79.66 | 1 |
| SC | $75.55 | 1 |
| SD | $76.16 | 1 |
| TN | $74.18 | 1 |
| TX | $75.39–$79.56 | 8 |
| UT | $76.15 | 1 |
| VA | $76.79–$86.08 | 2 |
| VI | $78.43 | 1 |
| VT | $76.39 | 1 |
| WA | $79.55–$86.39 | 2 |
| WI | $74.89 | 1 |
| WV | $75.73 | 1 |
| WY | $77.38 | 1 |
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
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 Galveston, 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
101
- Locality
- Galveston, TX
- Physician work
- 1.008
- Practice expense
- 0.993
- Malpractice
- 0.828
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.40 | × 1.008 | 1.4112 |
| Practice expense | 0.85 | × 0.993 | 0.8440 |
| Malpractice | 0.09 | × 0.828 | 0.0745 |
| Total RVUs | 2.3298 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Galveston, TX$77.82
Office: (1.4 × 1.008 + 0.85 × 0.993 + 0.09 × 0.828) × $33.4009 = $77.82
Facility: (1.4 × 1.008 + 0.41 × 0.993 + 0.09 × 0.828) × $33.4009 = $63.22
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
How 99498 has changed in Galveston, TX
99498 · Office / nonfacility
$77.82
Effective 2026-10-01
The base rate is $8.76 higher than on 2025-10-01, moving from $69.06 to $77.82 (12.7%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$69.06changed to$77.82
- 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 1.014 changed to 1.008
- Practice expense GPCI 1.000 changed to 0.993
- Malpractice GPCI 0.855 changed to 0.828
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$71.07changed to$69.06
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$69.91changed to$71.07
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$72.20changed to$69.91
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.62 changed to 0.63
- Work GPCI 1.023 changed to 1.014
- Practice expense GPCI 1.013 changed to 1.000
- Malpractice GPCI 0.703 changed to 0.855
January 1, 2023
RVU23A
$74.79changed to$72.20
- 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 1.032 changed to 1.023
- Practice expense GPCI 1.026 changed to 1.013
- Malpractice GPCI 0.550 changed to 0.703
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$75.05changed to$74.79
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.64 changed to 0.65
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$76.90changed to$75.05
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.62 changed to 0.64
- Work GPCI 1.026 changed to 1.032
- Practice expense GPCI 1.019 changed to 1.026
- Malpractice GPCI 0.695 changed to 0.550
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$76.78changed to$76.90
- Conversion factor 36.0391 changed to 36.0896
- Work GPCI 1.020 changed to 1.026
- Practice expense GPCI 1.011 changed to 1.019
- Malpractice GPCI 0.839 changed to 0.695
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$76.69changed to$76.78
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$73.44changed to$76.69
- 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
- Practice expense GPCI 1.012 changed to 1.011
- Malpractice GPCI 0.897 changed to 0.839
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$75.90changed to$73.44
- 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 1.019 changed to 1.020
- Practice expense GPCI 1.013 changed to 1.012
- Malpractice GPCI 0.955 changed to 0.897
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
No ratechanged to$75.90
Held through RVU16B, RVU16C, RVU16D.
January 1, 2015
RVU15A
No ratechanged toNo rate
Held through RVU15B, RVU15C, RVU15D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $77.82 | $63.22 | RVU26D |
| 2026-07-01 | $77.82 | $63.22 | RVU26C |
| 2026-04-01 | $77.82 | $63.22 | RVU26B |
| 2026-01-01 | $77.82 | $63.22 | RVU26A |
| 2025-10-01 | $69.06 | $68.74 | RVU25D |
| 2025-07-01 | $69.06 | $68.74 | RVU25C |
| 2025-04-01 | $69.06 | $68.74 | RVU25B |
| 2025-01-01 | $69.06 | $68.74 | RVU25A |
| 2024-10-01 | $71.07 | $70.41 | RVU24D |
| 2024-07-01 | $71.07 | $70.41 | RVU24C |
| 2024-04-01 | $71.07 | $70.41 | RVU24B |
| 2024-03-09 | $71.07 | $70.41 | RVU24AR |
| 2024-01-01 | $69.91 | $69.26 | RVU24A |
| 2023-10-01 | $72.20 | $71.86 | RVU23D |
| 2023-07-01 | $72.20 | $71.86 | RVU23C |
| 2023-04-01 | $72.20 | $71.86 | RVU23B |
| 2023-01-01 | $72.20 | $71.86 | RVU23A |
| 2022-10-01 | $74.79 | $74.08 | RVU22D |
| 2022-07-01 | $74.79 | $74.08 | RVU22C |
| 2022-04-01 | $74.79 | $74.08 | RVU22B |
| 2022-01-01 | $74.79 | $74.08 | RVU22A |
| 2021-10-01 | $75.05 | $74.69 | RVU21D |
| 2021-07-01 | $75.05 | $74.69 | RVU21C |
| 2021-04-01 | $75.05 | $74.69 | RVU21B |
| 2021-01-01 | $75.05 | $74.69 | RVU21A |
| 2020-10-01 | $76.90 | $76.53 | RVU20D |
| 2020-07-01 | $76.90 | $76.53 | RVU20C |
| 2020-04-01 | $76.90 | $76.53 | RVU20B |
| 2020-01-01 | $76.90 | $76.53 | RVU20A |
| 2019-10-01 | $76.78 | $76.41 | RVU19D |
| 2019-07-01 | $76.78 | $76.41 | RVU19C |
| 2019-04-01 | $76.78 | $76.41 | RVU19B |
| 2019-01-01 | $76.78 | $76.41 | RVU19A |
| 2018-10-01 | $76.69 | $76.33 | RVU18D |
| 2018-07-01 | $76.69 | $76.33 | RVU18C |
| 2018-04-01 | $76.69 | $76.33 | RVU18B |
| 2018-01-01 | $76.69 | $76.33 | RVU18AR1 |
| 2017-10-01 | $73.44 | $73.44 | RVU17D |
| 2017-07-01 | $73.44 | $73.44 | RVU17C |
| 2017-04-01 | $73.44 | $73.44 | RVU17B |
| 2017-01-01 | $73.44 | $73.44 | RVU17A |
| 2016-10-01 | $75.90 | $75.53 | RVU16D |
| 2016-07-01 | $75.90 | $75.53 | RVU16C |
| 2016-04-01 | $75.90 | $75.53 | RVU16B |
| 2016-01-01 | $75.90 | $75.53 | RVU16A |
| 2015-10-01 | Separate payment rules apply | Separate payment rules apply | RVU15D |
| 2015-07-01 | Separate payment rules apply | Separate payment rules apply | RVU15C |
| 2015-04-01 | Separate payment rules apply | Separate payment rules apply | RVU15B |
| 2015-01-01 | Separate payment rules apply | Separate payment rules apply | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Galveston, TX rate applies
Galveston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 16 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.
- Galveston
- Bacliff
- Bayou Vista
- Bolivar Peninsula
- Clear Lake Shores
- Dickinson
- 99498 in Friendswood · multiple payment areas
- Hitchcock
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
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