99407 Behav chng smoking > 10 min
What 99407 is
CMS fee schedule short descriptor: Behav chng smoking > 10 min.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 99407 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.50 | 0.33 | 0.04 | 0.87 | $29.06 |
| Facility (hospital, ASC) | 0.50 | 0.12 | 0.04 | 0.66 | $22.04 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 99407 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 99407? These codes are bundled into it
99407 is a Column 1 code in 62 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
0362T | Bhv id suprt assmt ea 15 min | 1 - modifier may bypass | Check pair |
0373T | Adapt bhv tx ea 15 min | 1 - modifier may bypass | Check pair |
0469T | Rta polarize scan oc scr bi | 0 - no modifier bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
92531 | Spontaneous nystagmus study | 0 - no modifier bypass | Check pair |
92532 | Positional nystagmus test | 0 - no modifier bypass | Check pair |
93792 | Pt/caregiver traing home inr | 1 - modifier may bypass | Check pair |
93793 | Anticoag mgmt pt warfarin | 0 - no modifier bypass | Check pair |
94002 | Vent mgmt inpat init day | 0 - no modifier bypass | Check pair |
94003 | Vent mgmt inpat subq day | 0 - no modifier bypass | Check pair |
94004 | Vent mgmt nf per day | 0 - no modifier bypass | Check pair |
94660 | Cpap initiation&mgmt | 0 - no modifier bypass | Check pair |
96105 | Assessment of aphasia | 1 - modifier may bypass | Check pair |
96125 | Cognitive test by hc pro | 1 - modifier may bypass | Check pair |
96127 | Brief emotional/behav assmt | 0 - no modifier bypass | Check pair |
96130 | Psycl tst eval phys/qhp 1st | 1 - modifier may bypass | Check pair |
96132 | Nrpsyc tst eval phys/qhp 1st | 1 - modifier may bypass | Check pair |
96136 | Psycl/nrpsyc tst phy/qhp 1st | 1 - modifier may bypass | Check pair |
96138 | Psycl/nrpsyc tech 1st | 1 - modifier may bypass | Check pair |
96146 | Psycl/nrpsyc tst auto result | 1 - modifier may bypass | Check pair |
96159 | Hlth bhv ivntj indiv ea addl | 0 - no modifier bypass | Check pair |
96164 | Hlth bhv ivntj grp 1st 30 | 0 - no modifier bypass | Check pair |
96165 | Hlth bhv ivntj grp ea addl | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
97151 | Bhv id assmt by phys/qhp | 1 - modifier may bypass | Check pair |
97153 | Adaptive behavior tx by tech | 1 - modifier may bypass | Check pair |
97154 | Grp adapt bhv tx by tech | 1 - modifier may bypass | Check pair |
97155 | Adapt behavior tx phys/qhp | 1 - modifier may bypass | Check pair |
97156 | Fam adapt bhv tx gdn phy/qhp | 1 - modifier may bypass | Check pair |
Showing 30 of 62 column 2 codes. Use the pair checker for any specific combination.
99407 is bundled into these codes
99407 appears as a Column 2 code in 146 active edits. Reported with one of these Column 1 codes on the same date of service, 99407 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0395T | Hdr elctr ntrst/ntrcv brchtx | 0 | Check pair |
0890T | Arhfcmrigtbs 1st tx day | 1 | Check pair |
0891T | Arhfcmrigtbs sbsq tx day | 1 | Check pair |
0892T | Arhfcmrigtbs sbsq per tx day | 1 | Check pair |
0944T | 3d cntr simula trgt lvr les | 0 | Check pair |
77261 | Ther radiology tx plng smpl | 0 | Check pair |
77262 | Ther radiology tx plng intrm | 0 | Check pair |
77263 | Ther radiology tx plng cplx | 0 | Check pair |
77280 | Ther rad simulaj field smpl | 0 | Check pair |
77285 | Ther rad simulaj field intrm | 0 | Check pair |
77290 | Ther rad simulaj field cplx | 0 | Check pair |
77293 | Respirator motion mgmt simul | 0 | Check pair |
77295 | 3-d radiotherapy plan | 0 | Check pair |
77300 | Radiation therapy dose plan | 0 | Check pair |
77301 | Radiotherapy dose plan imrt | 0 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.