Advance Care Planning Under Medicare: What's Covered and What It Costs
Yes—Medicare Part B covers advance care planning (ACP), the voluntary conversation with your provider about the care you'd want if you couldn't speak for yourself. You pay nothing when it's done during your "Welcome to Medicare" or yearly "Wellness" visit and your provider accepts assignment. If ACP happens as part of other medical treatment, the standard Part B deductible ($283 in 2026) and 20% coinsurance apply.
What advance care planning is under Medicare
Advance care planning (ACP) is a voluntary, face-to-face conversation between you and your doctor or qualified health professional about the medical care you would want—or want to avoid—if a future illness or injury left you unable to make decisions or speak for yourself. There is no medical exam involved; the service is the discussion itself.
During the visit, your provider can explain advance directives and, if you choose, help you complete the forms. Common documents include a living will, a health care proxy (also called a durable power of attorney for health care), and, in some states, a POLST or MOLST order for life-sustaining treatment. You can name a person to make decisions on your behalf and put your wishes in writing.
Participation is always optional. You can decline the conversation, stop at any time, and update or revoke your advance directive whenever you wish.
What Medicare Part B covers and what you pay
Medicare Part B covers ACP in two settings. First, it is covered as an optional element of your one-time "Welcome to Medicare" preventive visit and your annual "Wellness" visit. Second, Part B may cover ACP when it is provided separately as part of your medical treatment—for example, during an appointment about a serious diagnosis.
- Free: When ACP is delivered during your yearly Wellness visit (or Welcome to Medicare visit) by the same provider on the same day, and the provider accepts assignment, you pay nothing—no deductible and no coinsurance.
- Cost applies: When ACP is furnished outside a Wellness visit as part of other care, the Part B deductible ($283 in 2026) and 20% coinsurance apply after the deductible is met.
- Why the difference: For the no-cost scenario, providers append a preventive-services billing modifier so Medicare waives your share. Outside that, ACP is billed as a standard Part B service.
How the service is billed (and why it matters to you)
Providers bill ACP using two time-based codes. The first 16–30 minutes are billed under CPT code 99497, and each additional 30 minutes is billed under CPT code 99498. Understanding this helps explain a bill: a longer planning session may show more than one line item.
The cost-sharing waiver during a Wellness visit depends on correct billing. Since 2016, Medicare has required providers to add a preventive-services modifier when ACP is performed on the same day as the annual Wellness visit, which is what waives your coinsurance and deductible. If you receive a bill you didn't expect after a Wellness visit, it is reasonable to ask your provider's office whether ACP was billed correctly with that modifier.
Medicare Advantage and other plan considerations
If you have a Medicare Advantage (Part C) plan instead of Original Medicare, your plan must cover the same services Part B covers, including advance care planning. However, your specific copay, network rules, and out-of-pocket costs vary by plan, so confirm details with your plan before the visit.
Coverage and cost-sharing for any service can change with where and how it's delivered. If you're unsure whether a planned ACP discussion will be free, ask whether it will be billed as part of your Wellness visit beforehand.
Frequently asked questions
Does Medicare really pay for me to talk about end-of-life wishes?
Yes. Part B covers advance care planning as a voluntary service. It's free when done during your Welcome to Medicare or yearly Wellness visit with a provider who accepts assignment; otherwise the Part B deductible and 20% coinsurance apply.
Do I have to complete an advance directive during the visit?
No. The conversation is voluntary and completing any forms is optional. Your provider can explain documents like a living will or health care proxy and help you fill them out only if you want, and you can update or cancel them later.
Why did I get a bill after discussing advance care planning?
ACP is only free when billed as part of your Wellness visit with the required preventive-services modifier. If it was provided as part of other medical treatment, the $283 Part B deductible and 20% coinsurance apply. Ask the billing office how the visit was coded.
Can I do advance care planning more than once?
Yes. There is no limit on how often medically reasonable ACP can be provided. You can revisit and update your wishes as your health or preferences change, though cost-sharing may apply outside a Wellness visit.
Does Medicare Advantage cover advance care planning?
Medicare Advantage plans must cover what Part B covers, including ACP. Your exact copays, network rules, and costs vary by plan, so confirm coverage details with your plan before scheduling.
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Medicare Login Guide is an independent resource and is not affiliated with or endorsed by Medicare, the Centers for Medicare & Medicaid Services, or any government agency. This article is for general information only — confirm current figures and your specific options at medicare.gov or by calling 1-800-MEDICARE.