# CPT 99497

> Not at a published national rate. CPT 99497 carries status I (not valid) in the Q2 2015 release. Medicare uses a different code to report and pay for this service. Treat the blank amount as unpriced, not as $0.

## What it is

A face-to-face conversation with a patient, family member, or surrogate about the care they would want if they became too ill to speak for themselves. The clinician explains options such as life support, resuscitation, and comfort-focused care, and may help complete documents like an advance directive or healthcare proxy - though no form has to be signed for the discussion to count. This code covers the first block of that discussion, around half an hour; longer conversations continue with a separate add-on. It is a counselling service, not a procedure, and it can happen alongside a regular visit or as the entire reason for the appointment.

## Selected release

- Release: Q2 2015 (2015 B)
- Effective: April 1 – June 30, 2015
- Status indicator: I
- Office (non-facility) national allowed amount: not published
- Facility national allowed amount: not published
- Sequestration: not applied

## RVUs and formula

- Work RVU: not published
- Office (non-facility) practice expense RVU: not published
- Facility practice expense RVU: not published
- Malpractice RVU: not published
- Conversion factor: 35.7547
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q2 2015)
- CMS file: https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu15b.zip
- Parsed file: PPRRVU15_V0213_Current.csv, row 16,075
- Canonical page: https://localishealth.com/cpt/99497/2015/A
- Release-specific citation URL: https://localishealth.com/cpt/99497/2015/B
- Last significant update: 2026-08-04T03:05:48+00:00