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CPT code 99409: Substance-use screening, over 30 minutes2026 Medicare rate & RVUs

Reports structured alcohol or other non-tobacco substance-use screening with intervention when the service lasts more than 30 minutes.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · 99409

Substance-use screening, over 30 minutes

Office or facility?

Work RVUs
1.3
Total RVUs
1.66
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 99409 →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 99409 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 99409 covers

CPT 99409 identifies structured screening for alcohol or other substance use, excluding tobacco, followed by an intervention when the service lasts more than 30 minutes. AUDIT and DAST are screening tools associated with this service. The service addresses alcohol or other substance-use concerns and is distinct from tobacco-cessation counseling. Code selection distinguishes this longer screening-and-intervention service from the shorter time range represented by 99408.

Medicare lists 99409 with status N, meaning it is not covered by Medicare. The code represents a service lasting more than 30 minutes; 99408 represents the related 15-to-30-minute range. Alcohol-only screening and counseling codes G0442 and G0443 describe different services and are not substitutes for the full combined service in every circumstance.

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 99409 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

99409 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

99409 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
99409 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 99409 rate is calculated

Each of 99409’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 · 99409

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.30

1.30 RVUs× 1.000 GPCI

Practice expense0.65

0.65 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

2.0200

Conversion factor

$33.4009

Medicare rate

$67.47

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

Payment rules and modifiers for 99409

99409 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 · 99409

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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99409 isn’t priced in this setting.

99409 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 99409

    Substance-use screening, over 30 minutes1.3 wRVU

    Not priced

  • 99408

    Alcohol/substance screening, 15–30 minutes0.65 wRVU

    Not priced

  • G0442

    Alcohol screening, annual 15-minute preventive screen0.18 wRVU

    $18.70

  • G0443

    Alcohol counseling, brief behavioral service0.6 wRVU

    $34.40

How to choose

99408Alcohol/substance screening15–30 minutes
Both represent structured alcohol or other non-tobacco substance-use screening with intervention. 99409 is for more than 30 minutes; 99408 is for 15 to 30 minutes.
G0442Alcohol screeningAnnual 15-minute preventive screen
G0442 describes alcohol-misuse screening. It does not represent the longer combined screening-and-intervention service covered by 99409.
G0443Alcohol counselingBrief behavioral service
G0443 describes brief behavioral counseling for alcohol misuse. 99409 represents a longer combined service that may address alcohol or other non-tobacco substance use.

Codes related to 99409

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

Codes related to 99409
CodeHow it relatesNational office range
Same family
99408Alcohol/substance screening, 15–30 minutesRelated screening-and-intervention service for the 15-to-30-minute range.No office rate
Used instead
G0442Alcohol screening, annual 15-minute preventive screenAlcohol-misuse screening code for the screening portion of an alcohol-related service.$16.80–$24.67
G0443Alcohol counseling, brief behavioral serviceBrief behavioral counseling code for alcohol misuse, rather than the longer combined service.$31.92–$44.67

99409 billing questions

When should 99409 be chosen instead of 99408?

99409 represents structured screening and intervention lasting more than 30 minutes. 99408 represents the 15-to-30-minute range.

What does 99409 cover?

It represents structured screening for alcohol or other non-tobacco substance use together with an intervention. AUDIT and DAST are screening tools associated with the service.

Does Medicare cover 99409?

No. Medicare assigns status N, meaning the code is not covered.

Can tobacco-cessation counseling be reported as 99409?

No. 99409 concerns alcohol or other substance use, excluding tobacco. Tobacco-cessation counseling has separate codes, including 99406 and 99407.

How does 99409 differ from G0442 and G0443?

G0442 describes alcohol-misuse screening, and G0443 describes brief behavioral counseling for alcohol misuse. 99409 represents a longer combined screening-and-intervention service that can also address substances other than alcohol.

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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