$14.39
Both describe individual tobacco-cessation counseling. Choose 99407 when counseling exceeds 10 minutes; 99406 covers the shorter 3-to-10-minute interval.
On this page
CMS RVU26D · Effective 2026-10-01
99407 Smoking cessation Medicare reimbursement rates in Iowa
Reports an intensive, individual tobacco-cessation counseling visit when a clinician spends more than 10 minutes helping a patient stop tobacco use. Compare 99407 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 99407 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$27.32
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$20.90
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Behavioral counseling
About 99407: Intensive tobacco cessation counseling visit
Reports an intensive, individual tobacco-cessation counseling visit when a clinician spends more than 10 minutes helping a patient stop tobacco use.
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; the supplied payment facts list no additional code-specific payment rules.
Where the value comes from
- Work RVU0.50 · 57%
- Practice expense (office) RVU0.33 · 38%
- Malpractice RVU0.04 · 5%
62.5K
Medicare services in 2024 · #702 by national volume
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.
99407 compared with similar codes
Office rates for Iowa, from the same CMS release.
99401
No office ratePrev med cnsl indiv apprx 15
99401 is general individual preventive counseling. Use 99407 for focused counseling intended to help a tobacco user stop.
99408
No office rateAudit/dast 15-30 min
99408 concerns alcohol or substance-use screening and brief intervention, not tobacco-cessation counseling.
Compare 99407 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
$27.32
Facility
$20.90
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 99407 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
13,093
- Code
- 99407
- Physician work
- 0.50
- Practice expense
- 0.33
- Malpractice
- 0.04
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.50 | × 1.000 | 0.5000 |
| Practice expense | 0.33 | × 0.915 | 0.3020 |
| Malpractice | 0.04 | × 0.397 | 0.0159 |
| Total RVUs | 0.8178 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$27.32
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.5 | 1 |
| Practice expense | 0.33 | 0.915 |
| Malpractice | 0.04 | 0.397 |
(0.5 × 1 + 0.33 × 0.915 + 0.04 × 0.397) × $33.4009 = $27.32
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.5 | 1 |
| Practice expense | 0.12 | 0.915 |
| Malpractice | 0.04 | 0.397 |
(0.5 × 1 + 0.12 × 0.915 + 0.04 × 0.397) × $33.4009 = $20.90
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
13,09099403,,Prev med cnsl indiv apprx 45,N,+,1.46,1.10,,0.32,,0.08,2.64,1.86,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,09199404,,Prev med cnsl indiv apprx 60,N,+,1.95,1.32,,0.42,,0.12,3.39,2.49,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,09299406,,Behav chng smoking 3-10 min,A,,0.24,0.20,,0.06,,0.02,0.46,0.32,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,09399407,,Behav chng smoking > 10 min,A,,0.50,0.33,,0.12,,0.04,0.87,0.66,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,09499408,,Audit/dast 15-30 min,N,+,0.65,0.36,,0.14,,0.04,1.05,0.83,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,09599409,,Audit/dast over 30 min,N,+,1.30,0.65,,0.29,,0.07,2.02,1.66,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,09699411,,Preventive counseling group,N,+,0.15,0.45,,0.03,,0.01,0.61,0.19,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136