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CPT 99402: Preventive Counseling, 30-Minute Session
CPT code 99402 represents a discrete, approximately 30-minute counseling encounter focused on prevention and risk-factor reduction delivered separate from a preventive medicine visit. Nationally, this code matters as a mechanism to capture structured, age- and family-history–appropriate counseling that addresses lifestyle, behavioral risks, and preventive topics — services that can reduce long-term morbidity if delivered effectively. Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what CPT code 99402 covers clinically, where the service is typically delivered, and which payers commonly reimburse for this counseling-focused service. The publication summarizes standard service characteristics, common modifiers used with counseling codes (listed separately), and practical billing considerations such as session duration and separation from preventive medicine visits. It also outlines benchmarking and policy updates where available, and provides clinical context to help coding, billing, and compliance teams understand when CPT code 99402 is appropriate to report. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 99402 describes a standalone counseling visit focused on prevention and risk-factor reduction. The service is provided at an encounter separate from a preventive medicine visit and is tailored to the patient’s age, family history, and areas of concern. Use of this code corresponds to a counseling session lasting approximately 30 minutes.
Service Type
- Preventive counseling / Behavioral counseling
Typical Site of Service
- Outpatient clinic
- Physician office
- Other ambulatory care settings