CPT Code 99401: Preventive Medicine Counseling

The 99401 CPT code description identifies individual preventive medicine counseling sessions lasting approximately 15 minutes. The focus is on promoting health, preventing risks, and reducing the chance of established illness through counseling on topics like nutrition, exercise, and substance misuse.

CPT 99401 can be billed alongside an evaluation and management visit if the counseling services are reported separately and properly documented. Use modifier 25 with the E/M code to distinguish between the two procedures.

Only a physician or other qualified health care professional (QHP) may perform and bill preventive counseling under 99401. Counseling services by non-qualified clinical staff, such as medical assistants, do not meet the requirements for this code.

Select the code based on the duration of the counseling session and whether it was individual or group setting. For around 15 minutes, use 99401. For longer sessions, use 99402 through 99404. For group setting sessions, use 99424 or 99425.

Yes, assign the correct diagnosis code based on the counseling topic. Common examples include Z71.3 (dietary counseling) or Z71.85 (vaccine safety counseling). Linking the proper diagnosis code supports the medical necessity of the services provided.