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See a sample rate comparisonCPT 99412 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.
Preventive Medicine Counseling, Preventive Medicine Counseling Andor Risk Factor Reduction Intervention(S) Provided To Individuals In A Group Setting (Separate Procedure) Approximately 60 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 | 95 - Telemedicine - audio and video HD |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99412 |
| Medicaid Fee Schedule | $20.21 median of the 8 states in the free preview · View Medicaid rates for 99412 |
National average reimbursement for CPT 99412 by major payers:
$27.85
$28.14
$27.72
$36.45
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CPT 99412
5 of 25 sample ratesHigher to lower in this preview
Aimee Velasco
Holyoke Pediatric Associates, LLP
$63.97Published rateNaveen Pemmaraju
$51.75Published rateZahra Cain-Akbar
$29.45Published rateJoseph Krill
Texas Digestive Disease Consultants
$23.68Published rateDeniz Basci
Dallas Premier Plastic Surgery PLLC
$11.35Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 99412 vs. Other Preventive Medicine Services Codes
The CPT 99412 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 99412 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 |
|---|---|---|
| 99401-CPT | Low | Preventive Medicine Counseling, Preventive Medicine Counseling Andor Risk Factor Reduction Intervention(S) Provided To An Individual (Separate Procedure) Approximately 15 Minutes |
| 99402-CPT | Low | Preventive Medicine Counseling, Preventive Medicine Counseling Andor Risk Factor Reduction Intervention(S) Provided To An Individual (Separate Procedure) Approximately 30 Minutes |
| 99411-CPT | Low | Preventive Medicine Counseling, Preventive Medicine Counseling Andor Risk Factor Reduction Intervention(S) Provided To Individuals In A Group Setting (Separate Procedure) Approximately 30 Minutes |
| 99412-CPT | Low | Preventive Medicine Counseling, Preventive Medicine Counseling Andor Risk Factor Reduction Intervention(S) Provided To Individuals In A Group Setting (Separate Procedure) Approximately 60 Minutes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99412. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99412 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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