CPT code 99408: Alcohol/substance screening, 15–30 minutes2026 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 99408 covers

This service combines structured screening for alcohol or substance use other than tobacco with a brief intervention. A clinician may use a screening tool such as AUDIT or DAST, discuss the findings, and provide brief advice or guidance. The intervention may include feedback about results and advice to reduce use or seek additional care. It is reported when screening and intervention are provided in outpatient or primary care settings. The service is distinct from tobacco-cessation counseling, which addresses tobacco use specifically.

The code represents 15–30 minutes of screening and intervention. Medicare classifies it as not covered, with physician fee schedule status N, so Medicare does not cover it under this code. For a service lasting more than 30 minutes, 99409 is the duration-based sibling.

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 99408 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

99408 rates by state

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

How the 99408 rate is calculated

Each of 99408’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 99408

99408 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.

99408 compared with similar codes

How to choose

99409Substance-use screeningOver 30 minutes

Both codes cover structured screening and brief intervention for alcohol or non-tobacco substance use. Choose 99408 for 15–30 minutes and 99409 for more than 30 minutes.

99406Smoking cessationMore than 3 through 10 minutes

99406 is for tobacco-cessation counseling in its shorter time range. 99408 addresses alcohol or non-tobacco substance screening and intervention.

99407Smoking cessationMore than 10 minutes

99407 is for tobacco-cessation counseling in its longer time range. 99408 addresses alcohol or non-tobacco substance screening and intervention.

Codes related to 99408

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