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PreventivePreventive2026 Compliant

CPT 99406

2026 Billing Guide

Tobacco Cessation 3-10 min

Reimbursement

$13.36

Threshold

N/A

2026 Status

Active

What is CPT Code 99406?

CPT 99406 is defined as: An intermediate-level smoking and tobacco use cessation counseling visit lasting between 3 and 10 minutes. This preventive service involves providing specific advice to stop smoking, assessing the patient's readiness to quit, and developing a cessation plan. It is intended for patients who use tobacco and are ready to receive counseling, whether they have symptoms of a tobacco-related disease or not.

This code is primarily used for Preventive services. It falls under the category of Preventive Medicine and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.

2026 RVU Components

Relative Value Units (Non-Facility)

Standard Formula Applied

Work RVU

0.24

Physician Effort

PE (Non-Fac)

0.15

Practice Expense

Malpractice

0.01

Risk Factor

Total RVU

0.4

Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor

2026 CMS Policy Intelligence

efficiency shield

Strategically exempt from the -2.5% efficiency adjustment. CMS continues to incentivize preventive services that reduce long-term chronic disease costs.

audio only permanent

As a time-based preventive/behavioral service, 99406 is permanently eligible for audio-only delivery, supporting patients in areas with poor internet connectivity.

conversion factor

Utilizes the 2026 Non-QP rate of $33.40.

Administrative Framework

Place of Service

11 (Office)02 (Telehealth - Synchronous)10 (Telehealth - Patient Home)

NCCI Exclusions

Do not bill with:99407G0436G0437

Key Modifiers

25Significant, separately identifiable E/M service. Mandatory if tobacco counseling is performed during an E/M visit for a different condition (e.g., 99213-25 + 99406).
95Synchronous telemedicine service via audio and video.

Operational Requirements

time threshold

The face-to-face (or telehealth) time spent exclusively on tobacco cessation counseling must be greater than 3 minutes but not more than 10 minutes. If the time exceeds 10 minutes, bill 99407 instead.

annual limit

Medicare typically covers up to 8 counseling sessions per 12-month period (two attempts per year, 4 sessions per attempt).

cost sharing

$0 coinsurance and $0 deductible apply for Medicare beneficiaries, regardless of whether they have signs or symptoms of a tobacco-related disease.

documentation content

The note must include the total time spent, the counseling techniques used (e.g., 'The 5 A's'), and the specific cessation plan discussed.

Compliance Checklist

Detailed time tracking (cumulative for the month).
Specific clinical decision-making documentation.
Electronic care plan availability and access log.

Audit Defense

No specific audit defense elements defined.

2026 Update

Exempt from the mandatory -2.5% efficiency cut. $0 patient cost-sharing for all Medicare beneficiaries.

Common Clinical Scenarios

No clinical examples provided.

Target Specialties & Utilization

Primary CareCardiologyPulmonologyOncology

Typical Clinical Indications (ICD-10)

F17.210 (Nicotine dependence, cigarettes, uncomplicated)Z72.0 (Tobacco use)F17.220 (Nicotine dependence, chewing tobacco, uncomplicated)

Frequently Asked Questions

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