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CPT 99406 and 99407: 2026 Reimbursement, Modifiers, and Denial Resolution

CPT 99406 and 99407 smoking cessation billing 2026 hero banner: 99406 for 3-10 minutes and 99407 for over 10 minutes, Z71.6 valid but not on Medicare's covered diagnosis list, F17.2 dependence codes and Z72.0 as the correct pairing, 8 sessions per 12 months with state Medicaid variance up to 24, and 2026 dual conversion factor rates, from ClaimMax RCM.

CPT 99406 covers 3 to 10 minutes of face-to-face smoking and tobacco cessation counseling. CPT 99407 covers counseling that runs longer than 10 minutes. Both codes are time-based, so the counseling minutes have to appear in the note. Medicare pays $15.36 for 99406 in a non-facility setting in 2026. These two codes get billed less […]