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CPT 99407: Tobacco Cessation Counseling >10 Minutes

CPT code 99407 designates clinician-provided tobacco cessation counseling sessions that exceed 10 minutes. This preventive behavioral counseling code is used when clinicians deliver focused intervention to help patients stop tobacco use, an evidence-based service with implications for population health and chronic disease prevention. Nationally, tobacco cessation counseling is prioritized across public and private payers as part of preventive care strategies.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of billing context and clinical intent, typical sites of service, and how 99407 is positioned among tobacco cessation services. The publication also outlines common modifiers and payer considerations where available, benchmarks for counseling duration coding, and policy updates affecting coverage and documentation requirements.

This summary is intended to help billing professionals, clinicians, and policy analysts quickly understand the purpose of CPT code 99407, the clinical setting in which it is commonly used, and the payer landscape relevant to national reimbursement and coverage practices.

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Billing Code Overview

CPT code 99407 describes tobacco cessation counseling provided by a clinician when the counseling session lasts more than 10 minutes. The service focuses on counseling the patient on how to stop tobacco use, including behavioral strategies, motivation, and brief intervention techniques.

Service type: Preventive / behavioral counseling service
Typical site of service: Outpatient clinic or office-based setting, including primary care and specialty ambulatory clinics

Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related codes.

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CPT 99407: Tobacco Cessation Counseling >10 Minutes

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Billing Code Overview

Service type: Preventive / behavioral counseling service
Typical site of service: Outpatient clinic or office-based setting, including primary care and specialty ambulatory clinics

Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related codes.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult who uses combustible tobacco or nicotine products and presents to primary care, family medicine, internal medicine, or a designated tobacco cessation clinic requesting help to quit. The patient is evaluated during an office visit where the clinician documents tobacco-use status, assesses readiness to quit, reviews prior quit attempts, and provides structured counseling lasting more than 10 minutes. Counseling includes behavioral strategies, setting a quit date, development of a quit plan, discussion of pharmacotherapy options (nicotine replacement therapy, bupropion, varenicline), and arranging follow-up. The workflow: intake staff flags current tobacco users; rooming nurse documents tobacco history; clinician or trained counselor conducts the >10-minute cessation counseling session, documents duration and content, adds appropriate ICD-10 diagnosis for tobacco use or dependence, and selects 99407 for billing when counseling exceeded 10 minutes. Typical sites of service include outpatient clinic exam rooms, behavioral health clinics integrated in primary care, and specialized smoking cessation programs.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable E/M service by the same physician on the day of a procedure	Use when a separate evaluation or management visit is provided in addition to the tobacco cessation counseling on the same day.
`59`	Distinct procedural service	Use to indicate the counseling is distinct from another service on the same day when no more specific modifier applies.
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	Use when `99407` counseling is delivered live via telehealth video.
`G0`	Telehealth services for federally declared disaster or emergency	Use when telehealth cessation counseling occurs under an applicable emergency declaration.
`GT`	Via interactive audio and video telecommunications system (historical/ payer-specific)	Use with payors that accept `GT` for telehealth delivery of counseling.
`22`	Increased procedural services	Use when counseling required substantially greater effort or time beyond typical expectations and the payer allows modifier `22` with documentation.
`52`	Reduced services	Use when counseling session was partially reduced or not completed as originally intended.
`53`	Discontinued procedure	Use if the counseling session was started but discontinued due to patient inability to continue.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures (included per input list but rarely applicable)	Generally not applicable; include only if payer or institutional policy maps this to supervision context (rare).
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	Use when the service is provided via telemedicine (listed for emphasis when accepted by payer).

Taxonomy Code	Specialty	Notes
Data not available in the input.	Family Medicine	Family physicians commonly provide tobacco cessation counseling in primary care.
Data not available in the input.	Internal Medicine	Internists provide counseling during preventive or chronic care visits.
Data not available in the input.	Clinical Psychology / Behavioral Health	Behavioral health clinicians deliver structured cessation counseling and relapse prevention.
Data not available in the input.	Preventive Medicine / Public Health	Clinicians in smoking cessation programs and community clinics provide intensive counseling.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`F17.210`	Nicotine dependence, cigarettes, uncomplicated	Common diagnosis for patients receiving tobacco cessation counseling; documents dependence severity.
`F17.211`	Nicotine dependence, cigarettes, in remission	Used when patient has prior dependence but currently in remission; may guide counseling focus on relapse prevention.
`F17.213`	Nicotine dependence, cigarettes, with withdrawal	Relevant if the patient is currently undergoing withdrawal during cessation counseling.
`F17.220`	Nicotine dependence, chewing tobacco, uncomplicated	Applies when tobacco use is smokeless rather than combustible and counseling is targeted accordingly.
`Z71.6`	Tobacco abuse counseling	Indicates the encounter is for counseling related to tobacco use and supports billing for cessation services.
`Z72.0`	Tobacco use (habit)	Used to document current tobacco use status in the problem list and support counseling services.
`F17.290`	Nicotine dependence, other tobacco product, uncomplicated	Captures dependence on non-cigarette tobacco products when relevant to counseling.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99406`	Tobacco use counseling, intermediate, greater than 3 minutes up to 10 minutes	Used for shorter counseling sessions; `99407` is billed when counseling exceeds 10 minutes.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	May be billed the same day as `99407` with modifier `25` when a separate E/M is documented.
`99401`	Preventive medicine counseling, individual, typically 15 minutes (older/HCPCS variations may apply)	Preventive counseling codes are related but payor policies differ; used in preventive visits addressing health behavior change.
`G0436`	Alcohol and/or substance (other than tobacco) abuse structured screening and brief intervention services, 15 minutes	Conceptually related as a structured behavioral intervention code; not a substitute but provides context for brief intervention coding.
`98960`	Education and training for patient self-management by a qualified, nonphysician health care professional, individual, per 30 minutes	May be used in some settings for structured tobacco dependence education delivered by qualified non-physician staff.

CPT 99406: Tobacco Cessation Counseling, 3–10 Minutes

CPT-99408-SUBSTANCE-MISUSE-SCREENING-BRIEF-INTERVENTION-15-30-MINUTES

CPT 99408: Screening and Brief Intervention for Substance Misuse (15–30 min)

CPT-99409-SCREENING-BRIEF-INTERVENTION-SUBSTANCE-ABUSE-30-PLUS-MIN

CPT 99409: Screening and Brief Intervention for Substance Abuse >30 Minutes

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable E/M service by the same physician on the day of a procedure	Use when a separate evaluation or management visit is provided in addition to the tobacco cessation counseling on the same day.
`59`	Distinct procedural service	Use to indicate the counseling is distinct from another service on the same day when no more specific modifier applies.
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	Use when `99407` counseling is delivered live via telehealth video.
`G0`	Telehealth services for federally declared disaster or emergency	Use when telehealth cessation counseling occurs under an applicable emergency declaration.
`GT`	Via interactive audio and video telecommunications system (historical/ payer-specific)	Use with payors that accept `GT` for telehealth delivery of counseling.
`22`	Increased procedural services	Use when counseling required substantially greater effort or time beyond typical expectations and the payer allows modifier `22` with documentation.
`52`	Reduced services	Use when counseling session was partially reduced or not completed as originally intended.
`53`	Discontinued procedure	Use if the counseling session was started but discontinued due to patient inability to continue.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures (included per input list but rarely applicable)	Generally not applicable; include only if payer or institutional policy maps this to supervision context (rare).
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	Use when the service is provided via telemedicine (listed for emphasis when accepted by payer).

Taxonomy Code	Specialty	Notes
Data not available in the input.	Family Medicine	Family physicians commonly provide tobacco cessation counseling in primary care.
Data not available in the input.	Internal Medicine	Internists provide counseling during preventive or chronic care visits.
Data not available in the input.	Clinical Psychology / Behavioral Health	Behavioral health clinicians deliver structured cessation counseling and relapse prevention.
Data not available in the input.	Preventive Medicine / Public Health	Clinicians in smoking cessation programs and community clinics provide intensive counseling.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`F17.210`	Nicotine dependence, cigarettes, uncomplicated	Common diagnosis for patients receiving tobacco cessation counseling; documents dependence severity.
`F17.211`	Nicotine dependence, cigarettes, in remission	Used when patient has prior dependence but currently in remission; may guide counseling focus on relapse prevention.
`F17.213`	Nicotine dependence, cigarettes, with withdrawal	Relevant if the patient is currently undergoing withdrawal during cessation counseling.
`F17.220`	Nicotine dependence, chewing tobacco, uncomplicated	Applies when tobacco use is smokeless rather than combustible and counseling is targeted accordingly.
`Z71.6`	Tobacco abuse counseling	Indicates the encounter is for counseling related to tobacco use and supports billing for cessation services.
`Z72.0`	Tobacco use (habit)	Used to document current tobacco use status in the problem list and support counseling services.
`F17.290`	Nicotine dependence, other tobacco product, uncomplicated	Captures dependence on non-cigarette tobacco products when relevant to counseling.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99406`	Tobacco use counseling, intermediate, greater than 3 minutes up to 10 minutes	Used for shorter counseling sessions; `99407` is billed when counseling exceeds 10 minutes.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	May be billed the same day as `99407` with modifier `25` when a separate E/M is documented.
`99401`	Preventive medicine counseling, individual, typically 15 minutes (older/HCPCS variations may apply)	Preventive counseling codes are related but payor policies differ; used in preventive visits addressing health behavior change.
`G0436`	Alcohol and/or substance (other than tobacco) abuse structured screening and brief intervention services, 15 minutes	Conceptually related as a structured behavioral intervention code; not a substitute but provides context for brief intervention coding.
`98960`	Education and training for patient self-management by a qualified, nonphysician health care professional, individual, per 30 minutes	May be used in some settings for structured tobacco dependence education delivered by qualified non-physician staff.

CPT 99406: Tobacco Cessation Counseling, 3–10 Minutes

CPT-99408-SUBSTANCE-MISUSE-SCREENING-BRIEF-INTERVENTION-15-30-MINUTES

CPT 99408: Screening and Brief Intervention for Substance Misuse (15–30 min)

CPT-99409-SCREENING-BRIEF-INTERVENTION-SUBSTANCE-ABUSE-30-PLUS-MIN

CPT 99409: Screening and Brief Intervention for Substance Abuse >30 Minutes

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 99407: Tobacco Cessation Counseling >10 Minutes

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Billing Code Overview

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CPT 99407: Tobacco Cessation Counseling >10 Minutes

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References