CPT code 99409: Substance-use screening, over 30 minutes2026 Medicare rate & RVUs in Missouri
Reports structured alcohol or other non-tobacco substance-use screening with intervention when the service lasts more than 30 minutes.
CMS doesn’t publish an office rate for 99409 in Missouri.
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
On this page 9 sections
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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
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
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
—
99409 isn’t priced in this setting.
99409 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
Fee sheets · Coming soon
Put 99409 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist