Summary & Overview
CPT 99411: Group Preventive Counseling or Health Education, 30 Minutes
CPT code 99411 denotes a 30-minute group preventive counseling or health education visit delivered by a qualified provider. Nationwide, group counseling codes like 99411 support population health efforts by enabling delivery of preventive guidance, behavior-change counseling, and health education to multiple patients simultaneously, which can improve access and efficiency for services such as smoking cessation, nutrition counseling, chronic disease self-management, and preventive care outreach.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical intent and typical site of service, payer coverage context, common billing modifiers, and how 99411 fits within group-based preventive service delivery. The publication explains billing considerations and common operational uses of the code, summarizes which payers commonly recognize group counseling codes, and highlights where policy guidance or coverage definitions may influence billing practice.
This national-level summary is intended for clinicians, billing professionals, and policy analysts seeking a clear explanation of the code’s purpose, where it is typically used, and what topics the full publication covers, including benchmarks, coverage notes, and clinical context. Data not available in the input for specific payer rate benchmarks, associated taxonomies, and ICD-10 pairings.
Billing Code Overview
CPT code 99411 describes a group preventive counseling or health education visit delivered by a qualified health care provider to a group of patients for approximately 30 minutes. The service focuses on providing advice on maintaining and improving health through counseling, education, or preventive guidance.
Service type: Group preventive counseling / health education
Typical site of service: Outpatient or ambulatory setting where group education is provided
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves a primary care provider or allied health professional delivering a structured, face-to-face health education session to a small group of patients (often 5–20 participants) for approximately 30 minutes. For example, a family medicine clinic schedules a half-hour group smoking cessation counseling class for adult patients diagnosed with tobacco use disorder who have expressed readiness to quit. The session is conducted in a clinic conference room or community health space, led by a physician, nurse practitioner, physician assistant, clinical pharmacist, or health educator using standardized educational materials and interactive counseling. During workflow, patients check in at reception, complete brief intake forms documenting smoking status and readiness to change, attend the group counseling session, and receive handouts and follow-up appointment instructions. Billing staff link the session to the group counseling encounter and append appropriate modifiers for payer requirements before submitting claims to payors such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, or Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service | Use when a qualifying separate E/M encounter occurs the same day as the group counseling session and documentation supports distinct services |