CPT Code 99406: Smoking and Tobacco Use Cessation Counseling, 3–10 Minutes

Get insights on CPT code 99406 for 3–10 minute smoking cessation counseling, including billing, coverage, and documentation tips.

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Frequently asked questions

Yes, you can bill the 99406 CPT code with an evaluation and management (E/M) service if the tobacco use cessation counseling is a separately identifiable service. In such cases, append modifier -25 to the E/M code to indicate distinct counseling beyond the typical scope of the visit.

Yes, documentation of the duration is essential when billing the 99406 CPT code. The provider must record that the smoking and tobacco use cessation counseling lasted between 3–10 minutes. Without this, the cessation counseling visit may be denied or bundled under the E/M service.

Time-based documentation supports compliance with Medicare and Medicaid Services (CMS) and coding and documentation guidance protocols.

Yes, Medicare Part B covers 99406 for symptomatic tobacco users or those with tobacco-related conditions, such as chronic bronchitis, COPD, or cardiovascular disease. Coverage includes up to two cessation attempts per year, with each attempt allowing four intermediate or intensive sessions, totaling eight sessions annually.

The service must be furnished by a qualified provider and meet medical necessity criteria established by Medicare and Medicaid Services CMS and supported by a cessation counseling plan.