99403 Preventive medial cnsl indiv apprx 45
Also known as: preventive counseling 45 min, health coaching extended, risk reduction extended
Preventive medicine, individual counseling; approximately 45 minutes of physician or qualified health professional time devoted to risk factor reduction intervention and patient education.
In Plain Language
Extended health counseling; Comprehensive preventive coaching
Clinical Context
Used for individual preventive medicine counseling approximately 45 minutes in duration, providing comprehensive risk factor reduction intervention and patient education.
RVU Breakdown
| Work RVU | 1.46 |
| Total RVU | 1.46 |
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 1.46, this code ranks in the 42nd percentile among Evaluation & Management codes — 1.1x below the median (1.54). The highest wRVU in this category is 18.46.
Specialties
Frequently Asked Questions
What is CPT code 99403?
CPT 99403 (Preventive medial cnsl indiv apprx 45) is a Evaluation & Management code. Preventive medicine, individual counseling; approximately 45 minutes of physician or qualified health professional time devoted to risk factor reduction intervention and patient education.
Who uses CPT code 99403?
CPT 99403 is used by Family Medicine, Internal Medicine, All Specialties. Used for individual preventive medicine counseling approximately 45 minutes in duration, providing comprehensive risk factor reduction intervention and patient education.
When is CPT 99403 used?
Used for individual preventive medicine counseling approximately 45 minutes in duration, providing comprehensive risk factor reduction intervention and patient education.
Track This Code in RVU Edge
Log procedures, calculate wRVUs, and benchmark against MGMA data — all in one app.
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.