99498

Advance care planning, each additional 30 minutes

Medicare pricing data for 8,982 providers across 51 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Advance care planning, each additional 30 minutes (HCPCS code 99498) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $66.75, but hospitals typically charge $193.77 — a 2.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$13.35

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $66.75, your out-of-pocket cost would be approximately $13.35. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$66.75
Average Hospital Charge
$193.77
Markup Ratio
2.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$193.77
Medicare Allowed$66.75
Medicare Payment$53.25

Hospitals charge 2.9x more than what Medicare allows for this procedure. Medicare actually pays $53.25 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$84$31930175+26.5%
New York$75$27781410,462+11.9%
District of Columbia$74$19755657+10.4%
California$72$2597508,897+8.0%
Hawaii$72$19139724+7.9%
Washington$69$1992701,625+3.3%
Massachusetts$68$1843793,291+2.2%
New Mexico$68$24135236+1.6%
Connecticut$68$169168926+1.5%
Maryland$67$1762785,511+1.0%
Virginia$67$1532753,185+1.0%
Illinois$67$1633122,170+0.3%
New Jersey$66$2202903,025-0.5%
Montana$66$2101879-1.3%
Oregon$66$224111536-1.5%
Maine$65$23249152-2.2%
Arizona$65$1501351,585-2.3%
Florida$65$1304195,779-3.0%
Georgia$65$1741441,364-3.3%
New Hampshire$65$18365426-3.3%
Texas$65$1785465,788-3.3%
Pennsylvania$64$1654993,847-3.7%
Delaware$64$22921157-3.8%
Kansas$64$152108698-4.0%
Louisiana$63$155111673-5.0%
Michigan$63$1642751,877-5.0%
Nevada$63$17788797-5.4%
Missouri$63$1841661,013-5.5%
Colorado$63$1771451,455-5.9%
Rhode Island$63$13775720-6.4%
North Carolina$62$1564503,198-6.4%
South Carolina$62$1531841,073-6.5%
Vermont$62$13024131-6.6%
West Virginia$62$1623078-6.7%
Kentucky$62$145122460-7.2%
Wisconsin$62$271113664-7.3%
Ohio$62$2073421,915-7.6%
Alabama$62$13447227-7.6%
Minnesota$62$2372141,135-7.6%
Utah$61$1311001,252-8.4%
Idaho$61$17528122-9.0%
North Dakota$61$2101738-9.0%
Oklahoma$61$17052480-9.3%
Indiana$60$1721851,551-10.0%
Wyoming$60$19811418-10.1%
South Dakota$60$8915198-10.1%
Tennessee$59$1271741,317-11.9%
Iowa$58$17255491-12.4%
Mississippi$58$12231152-12.7%
Arkansas$58$12845450-13.3%
Nebraska$54$15959248-19.0%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber