# CPT 99403: Preventive medicine counseling, individual, approximately 45 minutes

Medicare CPT 99403 pays $88.18 in a non-facility setting and $62.13 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $81.70 in Arkansas to $113.75 in Alaska, a 39% spread.

Web page: https://www.med-reveal.com/rates/99403-cpt-fee-schedule
Section: Medical and Therapeutic Services
Billed by: Evaluation

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $88.18 |
| National facility | $62.13 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $113.75 | $86.00 |
| District of Columbia | $97.65 | $66.96 |
| New York | $95.70 | $66.63 |
| New Jersey | $95.54 | $66.21 |
| California | $95.43 | $64.61 |
| Washington | $94.30 | $64.60 |
| Massachusetts | $93.69 | $64.42 |
| Connecticut | $92.54 | $64.49 |
| Hawaii | $92.09 | $62.47 |
| Florida | $90.83 | $64.69 |
| Maryland | $90.58 | $63.42 |
| Colorado | $90.53 | $62.81 |
| Rhode Island | $90.03 | $63.12 |
| Oregon | $89.79 | $62.35 |
| Illinois | $89.54 | $64.37 |
| New Hampshire | $89.35 | $62.23 |
| Puerto Rico | $88.54 | $62.20 |
| Virgin Islands | $88.54 | $62.20 |
| Montana | $88.17 | $62.12 |
| Pennsylvania | $88.05 | $62.53 |
| Nevada | $87.77 | $61.69 |
| Delaware | $87.71 | $61.97 |
| Texas | $87.69 | $62.04 |
| Wyoming | $87.48 | $61.43 |
| Minnesota | $87.36 | $60.55 |
| Georgia | $87.09 | $62.23 |
| Michigan | $87.03 | $62.56 |
| Virginia | $86.77 | $61.16 |
| Arizona | $86.65 | $61.41 |
| North Dakota | $86.59 | $60.54 |
| Vermont | $86.49 | $60.70 |
| South Dakota | $86.40 | $60.35 |
| Utah | $85.70 | $61.21 |
| New Mexico | $85.67 | $61.78 |
| Maine | $85.55 | $60.65 |
| Louisiana | $85.11 | $61.32 |
| Missouri | $85.11 | $61.20 |
| Ohio | $85.00 | $61.22 |
| South Carolina | $84.99 | $60.91 |
| Wisconsin | $84.79 | $59.83 |
| North Carolina | $84.75 | $60.44 |
| West Virginia | $84.52 | $61.88 |
| Indiana | $84.12 | $59.97 |
| Kentucky | $83.87 | $60.71 |
| Idaho | $83.83 | $59.86 |
| Nebraska | $83.69 | $59.64 |
| Oklahoma | $83.65 | $60.39 |
| Tennessee | $83.60 | $59.92 |
| Iowa | $83.44 | $59.61 |
| Kansas | $83.33 | $59.77 |
| Alabama | $82.43 | $59.63 |
| Mississippi | $82.37 | $59.94 |
| Arkansas | $81.70 | $59.32 |

## Related codes

- 99401: Preventive medicine counseling, individual, approximately 15 minutes — https://www.med-reveal.com/rates/99401-cpt-fee-schedule
- 99402: Preventive medicine counseling, individual, approximately 30 minutes — https://www.med-reveal.com/rates/99402-cpt-fee-schedule
- 99404: Preventive medicine counseling, individual, approximately 60 minutes — https://www.med-reveal.com/rates/99404-cpt-fee-schedule
- 99406: Smoking and tobacco use cessation counseling, 3-10 minutes — https://www.med-reveal.com/rates/99406-cpt-fee-schedule
- 99407: Smoking and tobacco use cessation counseling, greater than 10 minutes — https://www.med-reveal.com/rates/99407-cpt-fee-schedule
- 99408: Alcohol and/or substance abuse structured screening and brief intervention, 15-30 minutes — https://www.med-reveal.com/rates/99408-cpt-fee-schedule
- 99409: Alcohol and/or substance abuse structured screening and brief intervention, greater than 30 minutes — https://www.med-reveal.com/rates/99409-cpt-fee-schedule
- 99411: Preventive medicine counseling, group, approximately 30 minutes — https://www.med-reveal.com/rates/99411-cpt-fee-schedule

Commercial negotiated rates for 99403 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules