# 99497 Advance Care Planning



## SUEV (Dec 3, 2015)

The code description for 99497 includes "first 30 minutes".  Does this mean it's non-billable if the planning is less than 30 minutes (like critical care requirements)?  Based on the CPT Assistant article "Time-based Codes Reporting" from 8/2014, I understand the 99498 wouldn't be added until 46 minutes has been documented (past the mid-point of 30 minutes for the add-on) but I'm not sure if we use the same rule for the base code.  If only 16 minutes of ACP is done, can we bill 99497?
Thanks!


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## Cynthia Hughes (Dec 17, 2015)

The CPT Assistant article on these codes said the midpoint rule applies so code 99497 can be reported for 16-45 minutes. Payers may have policy requiring that the time is met or exceeded.


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## klevy07 (Jan 11, 2016)

*99497 - Advance Care Planning*

I have the same question regarding the time. 
According to the 2016 Procedure Desk Reference it states " The provider discusses and shares advance care planning for up to 30 minutes with a patient, his family, or an individual representing the patient, regarding the future healthcare need of the patient.  ....."
It does not say that it is subject to the midpoint rule; it states "up to 30 minutes"


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