CPT code 99384: Adolescent preventive visit, new patient, ages 12–172026 Medicare rate & RVUs

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 99384 covers

Code 99384 identifies an initial comprehensive preventive medicine evaluation for a new patient aged 12 through 17. A physician or other qualified clinician typically provides the service in an office or clinic. The encounter focuses on preventive health rather than assessment of a specific illness or injury, with age-appropriate history and examination, counseling, anticipatory guidance, and risk-factor reduction. The age band distinguishes it from preventive visits for younger or older patients.

Medicare classifies 99384 as not covered, status N. It is a CPT Category I code for a new adolescent preventive visit; the established-patient counterpart for ages 12 through 17 is 99394. Select the code according to both patient status and age range, rather than using it for an established patient or a patient outside this age band.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 99384 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

99384 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 99384 rate is calculated

Each of 99384’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 99384

99384 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

99384 compared with similar codes

How to choose

99383Child preventive visitNew patient, age 5–11

Choose 99383 for a new patient aged 5–11; 99384 is for a new patient aged 12–17.

99394Adolescent preventive visitEstablished, ages 12–17

99394 is for an established patient aged 12–17; 99384 is for a new patient in that age range.

99385Preventive visitNew patient, age 18-39

99385 is the new-patient preventive code for ages 18–39; 99384 covers ages 12–17.

Codes related to 99384

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates