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99404 Preventive medial cnsl indiv apprx 60

Evaluation & Management

Also known as: preventive counseling 60 min, health coaching intensive, risk reduction comprehensive

Preventive medicine, individual counseling; approximately 60 minutes of physician or qualified health professional time devoted to risk factor reduction intervention and patient education.

In Plain Language

Comprehensive health counseling; Intensive preventive coaching

Clinical Context

Used for individual preventive medicine counseling approximately 60 minutes in duration, providing intensive risk factor reduction intervention and comprehensive patient education.

RVU Breakdown

Work RVU1.95
Total RVU1.95

Est. Medicare Payment

$65.13

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 1.95, this code ranks in the 65th percentile among Evaluation & Management codes — 1.3x the median (1.54). The highest wRVU in this category is 18.46.

Specialties

Family MedicineInternal MedicineAll Specialties

Frequently Asked Questions

What is CPT code 99404?

CPT 99404 (Preventive medial cnsl indiv apprx 60) is a Evaluation & Management code. Preventive medicine, individual counseling; approximately 60 minutes of physician or qualified health professional time devoted to risk factor reduction intervention and patient education.

Who uses CPT code 99404?

CPT 99404 is used by Family Medicine, Internal Medicine, All Specialties. Used for individual preventive medicine counseling approximately 60 minutes in duration, providing intensive risk factor reduction intervention and comprehensive patient education.

When is CPT 99404 used?

Used for individual preventive medicine counseling approximately 60 minutes in duration, providing intensive risk factor reduction intervention and comprehensive patient education.

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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.