CPT code 99406: Smoking cessation, more than 3 through 10 minutes2026 Medicare rate & RVUs

Medicare pays $15.36 for 99406 nationally in the office and $10.69 in a hospital or facility. Local office rates run $14.10–$19.51.

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

What 99406 covers

This code describes individual counseling aimed at helping a patient stop smoking or using tobacco. A physician or other qualified health professional may discuss the health effects of tobacco, the patient’s readiness to quit, triggers and barriers, and practical steps such as setting a quit date or considering support options. The service may occur during an office or outpatient visit when the patient’s tobacco use is addressed as a distinct counseling service.

Select 99406 when the documented counseling time is more than 3 minutes and no more than 10 minutes; longer counseling falls into the next time tier. Record the tobacco-use discussion, counseling provided, time, and the patient’s response or cessation plan. CMS values the service through physician work, practice expense, and malpractice inputs; its practice-expense valuation differs between office and facility settings.

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 99406 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

99406 rates by state

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

How the 99406 rate is calculated

Each of 99406’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 99406

99406 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.

99406 compared with similar codes

How to choose

99407Smoking cessationMore than 10 minutes

Use 99406 for more than 3 through 10 minutes of counseling; use 99407 when counseling exceeds 10 minutes.

99401Preventive counselingIndividual, approximately 15 minutes

99401 is general individual preventive counseling. 99406 is the tobacco cessation-specific service with its own time threshold.

99408Alcohol/substance screening15–30 minutes

99408 describes alcohol or drug screening and brief intervention, not counseling to stop smoking or tobacco use.

Codes related to 99406

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