Preventive · CMS status N
99396
Prev visit est age 40-64
Periodic comprehensive preventive medicine reevaluation, established patient, age 40-64.
Work RVU
1.90
2026 Medicare pays
$128.93
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 1.90 + Practice 1.84 + Malpractice 0.12 = 3.86 total
Work (your effort)Practice expenseMalpractice
When to use it
Commercial annual physical for an established adult patient age 40-64.
Documentation checklist
- ✓Interval history.
- ✓Multi-system exam.
- ✓Age-appropriate screening (mammography, colorectal, cardiovascular risk).
- ✓Lifestyle counseling and prevention plan.
Common pitfalls
- !Cannot also bill 99214 for the same problem — needs modifier 25 with a separately identifiable issue.
Common modifiers
2533
Common ICD-10 pairings
Z00.00
Pairs well with
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.