99396 Preventive visit established age 40-64
Also known as: preventive recheck middle age, well adult revisit 40-64, preventive follow-up middle aged
Periodic comprehensive preventive medicine re-evaluation and management of an individual including age and gender appropriate history, examination, counseling, and risk factor reduction interventions, established patient; age 40 through 64 years.
In Plain Language
Middle age check-up follow-up; Adult preventive follow-up
Clinical Context
Used for periodic preventive care revisit with a middle-aged adult age 40-64 years, including continued screening for chronic disease risk and preventive interventions.
RVU Breakdown
| Work RVU | 1.90 |
| Total RVU | 1.90 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
E&M codes require documentation of medical decision-making (MDM) complexity or total time spent on the encounter. For 2026, time-based coding includes all physician time on the date of the encounter.
How This Code Compares
With a work RVU of 1.90, this code ranks in the 62nd percentile among Evaluation & Management codes — 1.2x the median (1.54). The highest wRVU in this category is 18.46.
Specialties
Frequently Asked Questions
What is CPT code 99396?
CPT 99396 (Preventive visit established age 40-64) is a Evaluation & Management code. Periodic comprehensive preventive medicine re-evaluation and management of an individual including age and gender appropriate history, examination, counseling, and risk factor reduction interventions, established patient; age 40 through 64 years.
Who uses CPT code 99396?
CPT 99396 is used by Family Medicine, Internal Medicine. Used for periodic preventive care revisit with a middle-aged adult age 40-64 years, including continued screening for chronic disease risk and preventive interventions.
When is CPT 99396 used?
Used for periodic preventive care revisit with a middle-aged adult age 40-64 years, including continued screening for chronic disease risk and preventive interventions.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.