99406
Behav chng smoking 3-10 min
Smoking and tobacco-use cessation counseling visit, intermediate, more than 3 minutes up to 10 minutes. CMS 2026 wRVU 0.24. Up to 8 sessions per 12-month period per Medicare beneficiary. 99407 is the analogous code for greater-than-10-minute intensive counseling.
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.