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See a sample rate comparisonCPT 99408 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Alcohol Andor Substance (Othe, Alcohol Andor Substance (Other Than Tobacco) Abuse Structured Screening (E.G. Audit Dast) And Brief Intervention (Sbi) Services 15 To 30 Minutes
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Preventive Medicine Services |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | 59 - Distinct Procedural Service 25 - Significant, separately identifiable E/M service same day |
| Complexity Level | Low |
| ASAM Level | Level 0.5 - Early Intervention |
| Care Type | Screening |
| Setting | Outpatient |
| Medicare Fee Schedule | View Medicare rates for 99408 |
| Medicaid Fee Schedule | $28.625 median of the 8 states in the free preview · View Medicaid rates for 99408 |
National average reimbursement for CPT 99408 by major payers:
$41.30
$33.49
$37.47
$62.17
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CPT 99408
5 of 25 sample ratesHigher to lower in this preview
Matthew Mackwood
$118.73Published rateReuben Grothaus
$87.06Published rateSamantha Maplethorpe
$49.97Published rateCharles Sackmann
$45.90Published rateSamantha Maplethorpe
$40.79Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 99408 vs. Other Preventive Medicine Services Codes
The CPT 99408 code is part of the Evaluation and Management services used for Preventive Medicine Services. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 99408 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 99406-CPT | Low | Smoking And Tobacco Use Cessat, Smoking And Tobacco Use Cessation Counseling Visit Intermediate Greater Than 3 Minutes Up To 10 Minutes |
| 99407-CPT | Low | Smoking And Tobacco Use Cessation Counseling Visit Intensive, Greather Than 10 Minutes Medicaid Level Of Care 6, As Defined By Each State |
| 99408-CPT | Low | Alcohol Andor Substance (Othe, Alcohol Andor Substance (Other Than Tobacco) Abuse Structured Screening (E.G. Audit Dast) And Brief Intervention (Sbi) Services 15 To 30 Minutes |
| 99409-CPT | Low | Alcohol Andor Substance (Othe, Alcohol Andor Substance (Other Than Tobacco) Abuse Structured Screening (E.G. Audit Dast) And Brief Intervention (Sbi) Services Greater Than 30 Minutes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99408. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99408 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
To find out the cost of a specific medical procedure or service, especially for your specific location, you can use online tools that provide price transparency. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your specific location to get pricing information. You can also contact your insurance provider directly for their negotiated rates or the provider's billing department for an estimate.
CPT stands for Current Procedural Terminology. CPT codes are five-digit numerical codes used by healthcare providers and payers to describe medical, surgical, and diagnostic services. They are essential for understanding medical costs because they standardize the reporting of medical procedures, making it easier to identify and compare prices for the same service across different providers and locations.
Medical procedure costs can vary significantly due to several factors, including the type of facility (hospital vs. outpatient clinic), geographic location, the provider's reputation and expertise, the complexity of the service, and the negotiated rates between the healthcare provider and different insurance companies. These variations highlight the importance of price transparency tools like Payerprice to help consumers compare costs.
Payerprice offers a fee schedule lookup tool. To use it, you typically input the CPT code for the specific medical procedure or service you are interested in and your geographic location. The tool will then provide you with relevant pricing information based on its database, helping you understand potential costs before receiving care.