CPT Code 99402: Preventive Medicine Counseling Provided to an Individual, Approximately 30 Minutes

The most common modifier used with CPT code 99402 is modifier 25, which indicates a significant, separately identifiable evaluation and management service provided by the same physician on the same day as the preventive counseling.

Modifier 95 may also be used when the service is delivered via synchronous telemedicine.

The age limit for CPT code 99402 has been expanded in some states and programs. Age restrictions can vary by payer and jurisdiction, so providers should verify the applicable policies with each insurer or state program.

The primary difference between CPT codes 99401 and 99402 lies in the duration of preventive counseling provided: 99401 is for approximately 15 minutes of individual preventive medicine counseling or risk factor reduction intervention, whereas 99402 is for approximately 30 minutes.