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CPT code 99402: Preventive counseling, approximately 30 minutes2026 Medicare rate & RVUs

Individual preventive counseling at the approximately 30-minute level for a patient receiving risk-reduction or health behavior guidance.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · 99402

Preventive counseling, approximately 30 minutes

Office or facility?

Work RVUs
0.98
Total RVUs
1.26
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 99402 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 99402 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 99402 covers

99402 identifies individual preventive counseling, commonly focused on reducing health risks and supporting behavior change. A physician or other qualified health professional counsels one patient; examples may include nutrition, physical activity, or tobacco-related risk reduction. Its approximately 30-minute level distinguishes it from shorter and longer individual counseling codes. Group counseling is reported with different codes in the preventive counseling family.

Medicare does not cover 99402; its physician fee schedule status is N. This CPT Category I service represents an approximately 30-minute individual counseling level. For individual preventive counseling, 99401 represents approximately 15 minutes, 99403 approximately 45 minutes, and 99404 approximately 60 minutes. Group counseling codes 99411 and 99412 use a group format. Billing teams should match the documented service to the individual format and applicable approximate time level.

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 99402 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

99402 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

99402 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
99402 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 99402 rate is calculated

Each of 99402’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.

How the rate is built · 99402

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.98

0.98 RVUs× 1.000 GPCI

Practice expense0.90

0.90 RVUs× 1.000 GPCI

Malpractice0.06

0.06 RVUs× 1.000 GPCI

Adjusted RVUs

1.9400

Conversion factor

$33.4009

Medicare rate

$64.80

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 99402

99402 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.

Place of service · 99402

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

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99402 isn’t priced in this setting.

99402 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 99402

    Preventive counseling, approximately 30 minutes0.98 wRVU

    Not priced

  • 99401

    Preventive counseling, individual, approximately 15 minutes0.48 wRVU

    Not priced

  • 99403

    Preventive counseling, individual, about 45 minutes1.46 wRVU

    Not priced

  • 99411

    Group counseling, approximately 30 minutes0.15 wRVU

    Not priced

How to choose

99401Preventive counselingIndividual, approximately 15 minutes
99401 is the shorter individual preventive counseling level, approximately 15 minutes; 99402 represents approximately 30 minutes.
99403Preventive counselingIndividual, about 45 minutes
99403 represents approximately 45 minutes of individual preventive counseling, compared with approximately 30 minutes for 99402.
99411Group counselingApproximately 30 minutes
99411 is for preventive counseling delivered to a group. Use 99402 for individual counseling.

Codes related to 99402

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

Codes related to 99402
CodeHow it relatesNational office range
Same family
99401Preventive counseling, individual, approximately 15 minutesIndividual preventive counseling at the shorter approximately 15-minute level.No office rate
99403Preventive counseling, individual, about 45 minutesIndividual preventive counseling at the longer approximately 45-minute level.No office rate
99404Preventive counseling, individual, approximately 60 minutesIndividual preventive counseling at the longer approximately 60-minute level.No office rate
Used instead
99411Group counseling, approximately 30 minutesPreventive counseling in a group setting rather than individually.No office rate
99412Group preventive counseling, approximately 60 minutesPreventive counseling in a group setting rather than individually.No office rate

99402 billing questions

When should 99402 be selected instead of 99401 or 99403?

Use 99402 for individual preventive counseling at the approximately 30-minute level. The neighboring codes represent shorter or longer individual counseling time levels.

Is 99402 for individual or group counseling?

It identifies counseling for one patient. Codes 99411 and 99412 are for group preventive counseling.

Does Medicare cover 99402?

No. Medicare physician fee schedule status N identifies the service as not covered by Medicare.

Which time level does 99402 represent?

99402 represents approximately 30 minutes of individual preventive counseling.

Who provides the counseling represented by 99402?

A physician or other qualified health professional counsels one patient.

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

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