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    v1.0.30
    OpenPayerBilling CodesPreventive Behavior Intensive Program for Prevention Of DiabetesCPT cpt-0403t-group-diabetes-prevention-intensive-curriculum
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    CPT 0403T: Intensive Group Diabetes Prevention Education

    CPT code 0403T describes a group education service providing an intensive standard curriculum of behavior modification and lifestyle changes for diabetes prevention, delivered for one hour or more on a single day; the service type is group preventive education, typically performed in an outpatient clinic, community center, or similar group setting.

    For related coverage guidance, see recent payer policy updates: Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation, Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation, Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation.

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    Clinical & Coding Specifications

    Clinical Context

    A primary care clinic or community health center schedules a group diabetes prevention education session delivered by a licensed clinician (physician, nurse practitioner, physician assistant, or certified diabetes educator). A typical patient is an adult with prediabetes (e.g., elevated fasting glucose or A1c in the prediabetic range), obesity or overweight, and at least one cardiometabolic risk factor. The one-hour group session uses an intensive standard curriculum focused on behavior modification, diet, physical activity, and weight management designed to prevent progression to type 2 diabetes.

    The clinical workflow begins with identification of eligible patients during routine visits or population health outreach. Patients are invited and scheduled into a single-day group class lasting 60 minutes or longer. Before the session, staff verify eligibility, obtain informed consent for group education, and document relevant vitals and baseline labs in the electronic health record. The provider leads the curriculum, documents attendance, curriculum content, duration (one hour or more), and any individualized counseling provided within the group. Billing is submitted using 0403T on the date of service. Follow-up is documented separately and may include referrals to ongoing lifestyle programs or individual diabetes education if needed.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99401Preventive medicine counseling and/or risk factor reduction visit, individual, approximately 15 minutesShort one-on-one counseling visits that may precede referral to group prevention sessions or follow-up after group education.
    99402Preventive medicine counseling and/or risk factor reduction visit, individual, approximately 30 minutesLonger individual preventive counseling often used when more personalized instruction is required beyond the group session.
    G0447Face-to-face behavioral counseling for obesity, 15 minutesMedicare-covered brief behavioral counseling for obesity which may complement the group diabetes prevention curriculum.
    S9470Diabetes education, self-management training, face-to-face, per sessionUsed for diabetes education sessions; codes like this are commonly billed for structured diabetes education programs in coordination with prevention services.
    82947Glucose; quantitative, blood (e.g., reagent strip)Point-of-care glucose testing often performed before or after the session to document baseline metabolic status.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Q00000X
    207R00000X
    193200000X
    208D00000X
    207PP0204X
    1835P1200X
    1223S0112X
    207RH0003X

    Related Payer Policy Updates

    Specialty: Cardiology1 / 4

    10 rows

    PolicyPayerEffective Date
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure - Medical PolicyHealth-New-England2027-02-01
    Transcatheter Mitral Valve Repair Medical PolicyHealth-New-England2027-02-01
    Cardiac Electrophysiological (EP) Studies and Cardiac Ablation of Abnormal Electrical RhythmsCigna2027-01-15
    Biomarkers for Myocardial Infarction and Chronic Heart Failure Reimbursement PolicyHealthfirst2026-11-01
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2026-11-01
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2026-11-01
    Cardiology - TryvioCigna2026-11-01

    Related Codes

    CPT-0488T-GROUP-DIABETES-PREVENTION-REMOTE-INTENSIVE-EDUCATION

    CPT 0488T: Intensive Group Diabetes Prevention Education, Online

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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