# CPT 99404: Preventive medicine counseling, individual, approximately 60 minutes

Medicare CPT 99404 pays $113.23 in a non-facility setting and $83.17 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $105.07 in Arkansas to $146.86 in Alaska, a 40% spread.

Web page: https://www.med-reveal.com/rates/99404-cpt-fee-schedule
Section: Medical and Therapeutic Services
Billed by: Evaluation

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $113.23 |
| National facility | $83.17 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $146.86 | $114.85 |
| District of Columbia | $125.05 | $89.64 |
| New York | $122.85 | $89.32 |
| New Jersey | $122.47 | $88.62 |
| California | $121.81 | $86.24 |
| Washington | $120.61 | $86.34 |
| Massachusetts | $119.90 | $86.13 |
| Connecticut | $118.77 | $86.39 |
| Hawaii | $117.58 | $83.40 |
| Florida | $117.17 | $87.01 |
| Maryland | $116.26 | $84.92 |
| Colorado | $115.95 | $83.97 |
| Illinois | $115.62 | $86.57 |
| Rhode Island | $115.49 | $84.44 |
| Oregon | $115.00 | $83.33 |
| New Hampshire | $114.54 | $83.24 |
| Puerto Rico | $113.65 | $83.26 |
| Virgin Islands | $113.65 | $83.26 |
| Montana | $113.22 | $83.16 |
| Pennsylvania | $113.19 | $83.75 |
| Delaware | $112.62 | $82.92 |
| Texas | $112.62 | $83.02 |
| Nevada | $112.60 | $82.51 |
| Wyoming | $112.19 | $82.13 |
| Michigan | $112.18 | $83.95 |
| Georgia | $112.09 | $83.41 |
| Minnesota | $111.69 | $80.75 |
| Virginia | $111.30 | $81.75 |
| Arizona | $111.29 | $82.16 |
| North Dakota | $110.85 | $80.79 |
| Vermont | $110.81 | $81.05 |
| South Dakota | $110.57 | $80.51 |
| New Mexico | $110.38 | $82.81 |
| Utah | $110.17 | $81.92 |
| Maine | $109.77 | $81.05 |
| Louisiana | $109.58 | $82.14 |
| Missouri | $109.54 | $81.95 |
| Ohio | $109.43 | $81.98 |
| South Carolina | $109.28 | $81.50 |
| West Virginia | $109.18 | $83.06 |
| North Carolina | $108.83 | $80.78 |
| Wisconsin | $108.60 | $79.81 |
| Kentucky | $107.99 | $81.27 |
| Indiana | $107.95 | $80.08 |
| Oklahoma | $107.62 | $80.77 |
| Idaho | $107.59 | $79.93 |
| Tennessee | $107.36 | $80.04 |
| Nebraska | $107.34 | $79.60 |
| Iowa | $107.06 | $79.56 |
| Kansas | $107.01 | $79.83 |
| Mississippi | $106.05 | $80.17 |
| Alabama | $105.98 | $79.68 |
| Arkansas | $105.07 | $79.25 |

## 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
- 99403: Preventive medicine counseling, individual, approximately 45 minutes — https://www.med-reveal.com/rates/99403-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 99404 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