99406 CPT Code (2026): Smoking Cessation

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• 99406

99406 CPT Code (2026): Smoking Cessation

CPT code 99406 for brief smoking and tobacco cessation counseling, 3-10 minutes. Billing guidance for behavioral health providers.

Quick Reference

Code

99406

Code System

CPT

Category

CPT Codes

Published

Mar 4, 2026

Reading Time

7 min

CPT® is a registered trademark of the American Medical Association. All CPT code descriptions on this page are paraphrased in original wording; consult the current CPT® codebook published by the AMA for authoritative descriptors.

Understanding CPT Code 99406: Tobacco Cessation Counseling, 3-10 Minutes

CPT code 99406 covers brief smoking and tobacco use cessation counseling delivered face-to-face for 3 to 10 minutes. Tobacco cessation counseling is a preventive service with direct relevance to behavioral health treatment, where smoking and tobacco use rates far exceed those in the general population. This code provides a straightforward billing mechanism for brief interventions that can meaningfully impact patient health outcomes.

For behavioral health providers, routine screening for tobacco use and delivery of brief cessation counseling represents both a clinical best practice and a reimbursable service. CPT 99406 allows providers to capture this work without altering their existing visit workflow.

Definition and Purpose

CPT code 99406 describes smoking and tobacco use cessation counseling visit of intermediate duration, greater than 3 minutes up to 10 minutes. The code applies to face-to-face counseling focused specifically on helping the patient stop using tobacco products.

Scope of service. The counseling must address tobacco or smoking cessation directly. It may include assessing the patient’s readiness to quit, discussing the health risks of continued tobacco use, reviewing cessation strategies, recommending pharmacotherapy, providing motivational interviewing around quitting, and setting quit dates.

Tobacco products covered. The code applies to cessation counseling for all forms of tobacco, including cigarettes, cigars, pipe tobacco, smokeless tobacco (chewing tobacco and snuff), and other tobacco products. While vaping and e-cigarette cessation may be addressed using this code by some payers, coverage varies and providers should verify with individual payers.

Provider qualifications. CPT 99406 can be reported by physicians, nurse practitioners, physician assistants, clinical psychologists, and other qualified healthcare providers acting within their scope of practice. The provider must personally deliver the counseling face-to-face.

Standalone or add-on. Unlike many behavioral health billing codes, 99406 can be reported as a standalone service or in combination with other services performed on the same date. It does not require a separate E&M visit to be billed, though it is frequently reported alongside one.

When to Use in Behavioral Health

Tobacco cessation counseling is particularly important in behavioral health settings due to the disproportionate burden of tobacco use among patients with psychiatric and substance use disorders.

Intake and assessment visits. During new patient intakes at behavioral health facilities, providers routinely screen for tobacco use as part of a comprehensive assessment. When a brief cessation counseling intervention is provided during this screening (3-10 minutes), 99406 can be reported in addition to the primary intake service code.

Substance use disorder treatment. Patients in treatment for alcohol or drug use disorders have exceptionally high rates of tobacco use. Integrating tobacco cessation counseling into SUD treatment is increasingly recognized as a clinical best practice. Brief interventions during medication management visits, group orientation sessions, or individual check-ins can qualify for 99406.

Medication management visits. When a prescribing provider discusses tobacco cessation pharmacotherapy such as nicotine replacement therapy, bupropion, or varenicline during a medication management appointment, the time spent on cessation counseling can support a 99406 claim if it meets the 3-minute minimum.

Residential treatment programs. Many behavioral health residential programs have adopted smoke-free campus policies. Brief cessation counseling provided to residents who use tobacco, including education about cessation resources and coping strategies, can be captured with 99406.

Psychiatric follow-up visits. Routine follow-up visits provide natural opportunities for brief tobacco cessation interventions, particularly for patients whose psychiatric medications interact with tobacco (such as clozapine, olanzapine, and other medications affected by CYP1A2 induction from smoking).

Documentation Requirements

Documentation for CPT 99406 must be clear and specific, though the requirements are less extensive than for many behavioral health codes given the brief nature of the service.

Duration of counseling. Document the time spent on tobacco cessation counseling. The note must support that at least 3 minutes but no more than 10 minutes of face-to-face counseling was provided. If counseling exceeds 10 minutes, report CPT 99407 instead.

Content of counseling. Describe the specific cessation counseling activities performed. Examples include assessing current tobacco use patterns and history, evaluating readiness to quit using a validated framework such as the stages of change model, discussing health risks specific to the patient’s clinical situation, reviewing cessation strategies including behavioral techniques and pharmacotherapy options, setting a quit date or establishing goals, and providing referrals to cessation resources such as quitlines.

Tobacco use status. Document the patient’s current tobacco use status, type of tobacco products used, quantity and frequency of use, and any prior quit attempts.

Separate from E&M documentation. If 99406 is billed alongside an E&M service on the same date, the cessation counseling must be documented as a distinct service. The time spent on cessation counseling should not overlap with the time supporting the E&M code.

Billing and Reimbursement

As of March 2026, Medicare reimburses CPT 99406 as a covered preventive service with no patient cost-sharing when billed with an appropriate diagnosis code for tobacco use.

Medicare coverage details. Medicare Part B covers tobacco cessation counseling for all beneficiaries who use tobacco, regardless of whether they have a tobacco-related disease or symptoms. Coverage includes two cessation attempts per 12-month period, with up to four counseling sessions per attempt. Both 99406 and 99407 count toward this eight-session annual maximum. There is no beneficiary copay or deductible for this preventive service when billed correctly.

Diagnosis coding. Use ICD-10 codes from the F17 category (nicotine dependence) or Z87.891 (personal history of nicotine dependence) to support the claim. The specific F17 code should reflect the type of tobacco product and the patient’s dependence status.

Commercial payer coverage. Under the Affordable Care Act, most commercial health plans must cover tobacco cessation counseling as a preventive service without cost-sharing. Coverage typically mirrors or exceeds Medicare’s benefit, though specific policies vary by payer.

Reimbursement rates. Medicare reimbursement for 99406 varies by geographic region but is generally modest given the brief duration of the service. The clinical value of the intervention and its contribution to overall patient health outcomes should be weighed alongside the direct reimbursement amount.

Same-day billing with E&M. When billing 99406 on the same date as an E&M service, append modifier 25 to the E&M code. The cessation counseling must be documented as a separate service with distinct time and content.

Common Modifiers

Modifier 25 is applied to the E&M code (not to 99406) when both services are reported on the same date. This indicates that the E&M service was significant and separately identifiable from the cessation counseling.

Modifier 33 indicates that the service is a preventive service. Some payers require this modifier to waive patient cost-sharing for tobacco cessation counseling. Check individual payer requirements, as not all payers use this modifier.

Modifier 95 may be applied for tobacco cessation counseling delivered via synchronous telemedicine. Medicare and many commercial payers extended telehealth coverage for cessation counseling, particularly following the expansion of telehealth services. Verify current telehealth policies with each payer.

Modifier SC (medically necessary service or supply) may be required by some Medicaid programs or other payers to distinguish the service from routine screening.

Compliance Considerations

While tobacco cessation counseling is a relatively low-risk billing area, providers should observe the following compliance practices.

Time accuracy. The distinction between 99406 (3-10 minutes) and 99407 (greater than 10 minutes) is based solely on time. Document time accurately and select the code that matches the actual duration of counseling. Routinely billing 99406 for cessation encounters that consistently last exactly 3 minutes may attract scrutiny.

Frequency limits. Track the number of cessation sessions provided to each Medicare beneficiary to ensure compliance with the two-attempt, four-session-per-attempt limit. Exceeding these limits will result in claim denials.

Distinct service documentation. When billing 99406 alongside other services, ensure that the cessation counseling is documented as a clinically distinct intervention. Do not double-count time that supports other codes.

Staff training. Train clinical staff on proper documentation practices for cessation counseling, including time recording, content documentation, and appropriate diagnosis coding.

Screening integration. Consider integrating standardized tobacco screening into your intake process and EHR workflows. This creates natural opportunities for brief interventions and ensures consistent identification of patients who could benefit from cessation counseling.

Quality reporting. Tobacco cessation counseling aligns with several quality measures, including MIPS measures related to preventive care screening. Proper documentation and coding of 99406 can support quality reporting requirements.

Related Billing Codes

• 99354
• 99355
• 99396
• 99407
• 99408
• 99409

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