Although the use of tobacco products is on the decline in the United States, the consumption of alcohol and other addictive substances remains a common preventable problem. As a result, the American Medical Association’s (AMA’s) CPT Editorial Panel included a spotlight on reporting tobacco, alcohol, and substance use cessation, counseling, screening, and intervention codes in its September 2024 release of CPT Assistant.
While these behavior change intervention codes (99406-99409) have not been altered since 2008, the latest issue of CPT Assistant added more background information, updated statistics, clarified guidance, and offered coding scenarios. This article will cover the highlights of that publication, but make sure to check with your specific payer(s) to see whether these CPT® codes or HCPCS Level II codes should be used to most accurately report these services.
- Smoking Cessation
- Alcohol and/or Substance Abuse Screening and Brief Intervention
- HCPCS Codes for Medicare Patients
- Reporting Behavior Change Intervention Codes with Modifiers
CPT® codes for Smoking Cessation
The following codes are used to report counseling by a physician or non-physician practitioner with a patient for smoking cessation:
Code | Description | 2024 wRVU | Total National non-facility RVUs | Total National facility RVUs |
99406 | Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes | 0.24 | 0.44 | 0.35 |
99407 | greater than 10 minutes | 0.50 | 0.82 | 0.74 |
Code 99407 is not an add-on code. It should never be reported with 99406, according to CPT parenthetical notes. Only report the code that corresponds to the amount of time spent. Document time in the medical record, and do not double count the time of any other service on the same day.
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