Billable under CPT 99497 / 99498

Advance care planning
at scale.

Patients download the CareGoals app, have the conversation at home with Sage AI, and your practice reviews, signs, and bills. Clinically valid. Legally documented. Reimbursable.

37%
of adults have an advance directive
JAMA Internal Medicine, 2023
$86
CPT 99497 reimbursement (first 30 min)
CMS Physician Fee Schedule
92%
of patients want ACP conversations
Journal of Palliative Medicine
16 min
average primary care visit length
Annals of Internal Medicine

ACP is a quality measure, a revenue opportunity, and a moral imperative. So why isn't it happening?

The barriers aren't clinical. They're operational. ACP conversations take time physicians don't have, generate documentation that's hard to standardize, and the resulting wishes often can't be found when they matter most.

Time barrier

A meaningful ACP conversation takes 30-60 minutes. Most primary care visits are 16 minutes. The math doesn't work inside the clinic walls.

Documentation barrier

Handwritten forms, PDFs in filing cabinets, notes buried in EHR free text. When the ambulance arrives, nobody can find them.

Billing barrier

99497/99498 are some of the most under-billed codes in medicine. Practices leave millions on the table because the workflow doesn't exist.

Accessibility barrier

Even when an advance directive exists, it's rarely available at the point of care. 70% of directives never make it into the medical record.

Four steps. Zero physician time wasted.

Your patients have the conversation at home. You review and bill. CareGoals handles everything in between.

1

Recommend the app

Your staff recommends CareGoals to eligible patients. They download the iPhone app and begin at home -- around the kitchen table, on their own time.

2

Sage guides the conversation

Sage AI leads a voice-first, empathetic conversation. Goals of care, treatment preferences, surrogate decision-makers, specific clinical scenarios. Not a form -- a real conversation.

3

Physician reviews and signs

AI-generated documentation arrives in your review queue. 3-5 minutes to review, annotate, and attest. Billable under 99497/99498 with full documentation. Incident-to billing supported.

4

ComfortCard delivers

Care wishes are stored on the patient's ComfortCard -- accessible via QR code, Apple Wallet, or fridge magnet. Always findable when it matters most.

RECOMMEND -- CONVERSE -- REVIEW -- DELIVER

Not a form.
A conversation.

CareGoals is an iPhone app that turns advance care planning into something families actually want to do. Sage AI guides a voice-first conversation -- unhurried, empathetic, clinically structured -- that captures wishes, stories, and care preferences in a format physicians can review and sign.

  • Voice-first. Talk naturally. Sage listens, remembers, asks the next best question.
  • Kitchen table ready. Designed for home, not clinic. Sit with your loved one and let Sage guide you.
  • Stories preserved. Beyond directives -- capture the context, the values, the why behind every wish.
  • Clinically valid. Reviewed and signed by a licensed physician. FHIR ADI compliant.
  • ComfortCard output. Wishes go straight to a digital care wallet your family carries everywhere.
Download on the App Store iPhone app -- coming soon
Guided by Sage AI
Tell me about what matters most to you when you think about your health and your future.
I want to be able to stay in my home as long as possible. My garden is everything to me.
That's beautiful. Your garden clearly gives you a sense of purpose. Let's talk about what "staying home" looks like for you in different situations...
Tap to speak or type your response...
"Every family has a story worth preserving. CareGoals doesn't just capture directives -- it captures the person behind them."
-- The emotional heart of co-op.care
Revenue Opportunity

The ACP revenue you're leaving on the table.

CareGoals turns every eligible patient into a billable ACP encounter. The app does the heavy lift. Your physicians review and attest.

Code Description Reimbursement CareGoals Workflow
99497 ACP first 30 minutes, face-to-face $86.24 Sage AI conversation + physician attestation
99498 ACP each additional 30 minutes $74.88 Extended conversation, complex scenarios
G0438 Annual Wellness Visit (initial) $175+ ACP layered onto AWV increases per-visit revenue
G0439 Annual Wellness Visit (subsequent) $125+ Annual ACP refresh during subsequent AWV
$68,800

in new annual revenue. A practice with 2,000 Medicare patients. 40% complete ACP via CareGoals = 800 encounters at $86 each. Your physician spends 3-5 minutes per review. The app does the rest.

Where do the wishes go?

Every CareGoals conversation produces a living document stored on ComfortCard -- a digital care wallet your patients carry everywhere. When it matters most, their wishes are always findable.

  • QR code access for first responders
  • Apple Wallet integration
  • HSA/FSA eligibility tracking
  • Family sharing with permissions
Learn about ComfortCard
Digital Care Wallet
Margaret Chen
For Practices

Pricing that pays for itself.

CareGoals pays for itself with the first few ACP encounters. No long-term contracts. Cancel anytime.

Starter
$0
Free forever
  • ACP education materials
  • Billing code reference guide
  • Sample conversation scripts
  • 5 patient conversations/mo
Start Free
Health System
Custom
enterprise pricing
  • Everything in Practice
  • Multi-site deployment
  • EHR integration (Epic, Cerner)
  • Quality measure reporting
  • Dedicated success manager
Contact Us

Three steps around
the kitchen table.

Download CareGoals. Sit with your loved one. Let Sage guide the conversation that matters most. No forms, no legalese, no rush. Just a conversation about what you value, what you want, and who speaks for you when you can't.

1

Download

Get CareGoals on your iPhone. Create your profile in 30 seconds.

2

Converse

Sage guides you through goals, values, and care preferences. Voice-first. At your pace.

3

Carry

Your wishes live on ComfortCard -- always with you, always findable, shareable with family.

The Century Plan

Your care goals evolve across a lifetime. CareGoals grows with you -- from your first conversation to long-term milestones. Revisit, update, and deepen your plan at every stage.

40
First conversation
55
Health changes
65
Medicare transition
75
Care planning
85+
Legacy & comfort