CPT code 99407: Smoking cessation, more than 10 minutes2026 Medicare rate & RVUs in Maryland
Reports an intensive, individual tobacco-cessation counseling visit when a clinician spends more than 10 minutes helping a patient stop tobacco use.
Medicare pays $29.25–$32.07 for 99407 in the office in Maryland, from Rest of Maryland to Washington, DC area. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 99407 covers
A physician or other qualified health professional uses this service for focused, individual counseling with a patient who uses tobacco. The discussion may assess readiness to quit, advise cessation, address barriers or triggers, and develop a quit plan. It is distinct from simply recording tobacco use or screening for tobacco exposure; the encounter must include active cessation counseling. Counseling may occur in an office or facility setting.
Select 99407 when the time spent on the tobacco-cessation counseling exceeds 10 minutes. The shorter counseling level, 99406, is for a different time threshold. Document the tobacco-use concern, the counseling and cessation strategies discussed, and the time devoted to that work. Report the service for the counseling visit, not for the number of tobacco products or cessation strategies discussed. CMS assigns work and practice-expense values to this service.
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 99407 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$29.25 to $32.07
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $30.45 | $22.92 |
| Rest of Maryland | $29.25 | $22.15 |
| Washington, DC area | $32.07 | $23.81 |
How the 99407 rate is calculated
Each of 99407’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 · 99407
RVUs × geographic indexes × conversion factor
Work0.50
0.50 RVUs× 1.000 GPCI
Practice expense0.33
0.33 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
0.8700
Conversion factor
$33.4009
Medicare rate
$29.06
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99407
99407 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 · 99407
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$29.06
- Non-facility (office)
- $29.06
- Facility
- $22.04
Higher because the practice carries its own overhead.
99407 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 99406Smoking cessationMore than 3 through 10 minutes
- Both describe individual tobacco-cessation counseling. Choose 99407 when counseling exceeds 10 minutes; 99406 covers the shorter 3-to-10-minute interval.
- 99401Preventive counselingIndividual, approximately 15 minutes
- 99401 is general individual preventive counseling. Use 99407 for focused counseling intended to help a tobacco user stop.
- 99408Alcohol/substance screening15–30 minutes
- 99408 concerns alcohol or substance-use screening and brief intervention, not tobacco-cessation counseling.
99407 billing questions
When should 99407 be selected instead of 99406?
Use 99407 when tobacco-cessation counseling exceeds 10 minutes. Use 99406 for the shorter 3-to-10-minute counseling interval.
What documentation supports 99407?
Record the patient's tobacco-use concern, the cessation counseling provided, and the time spent on that counseling. The note should show active cessation work, such as assessing readiness or developing a quit plan.
Is this code for tobacco screening alone?
No. It represents counseling to help a patient stop tobacco use, not simply asking about or documenting tobacco use.
Does 99407 include cessation medication or products?
The code describes the counseling service. It does not describe a medication or cessation product.
Is the time based on the length of the whole visit?
Select the code based on time devoted to tobacco-cessation counseling, rather than unrelated work during the encounter. Document the counseling time.
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
Show the CMS file lines behind this rate
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