99406
Behav chng smoking 3-10 min
Smoking and tobacco-use cessation counseling visit, intermediate, more than 3 minutes up to 10 minutes. Up to 8 sessions per 12-month period per Medicare beneficiary. 99407 is the analogous code for greater-than-10-minute intensive counseling.
Published by RVUDoc. Numeric data: CMS RVU26C, effective 2026-07-01. Page updated 2026-09-23. Calculation limits and editorial policy.
Fee-schedule estimate before claim adjustments. Coverage, setting and payer rules still apply.
Billing guidance for 99406 is locked
- When to use it: the exact clinical situations that support billing 99406
- Documentation checklist: the 7 elements your note needs before submitting
- Common pitfalls: the 6 mistakes that get 99406 downcoded or denied
Payer notes
Medicare covers up to 8 cessation-counseling sessions per 12-month period per beneficiary with no cost share when the diagnosis is tobacco dependence (F17.xxx). Medicare Advantage typically follows Medicare. Commercial payers vary widely: many cover unlimited sessions, some apply a copay, some require pre-authorization for pharmacotherapy. Coverage extends to e-cigarette and smokeless tobacco use in most plans. State Medicaid coverage varies; check your state. Telehealth delivery is accepted at POS 02 or POS 10 with modifier 95 for Medicare and most commercial plans.
Related codes
These include alternative services and possible add-ons. Listing codes together does not establish that they can be billed together; check the applicable edits and payer policy.
See what 99406 adds to your year
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