2025 CPT code 99412
Effective Date: N/A Evaluation and Management - Preventive Medicine Services Feed
Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes.
Modifier 25 can be appended to an E/M code if a separately identifiable service is performed on the same day as the preventive medicine service.
The medical necessity of this code must be supported by the presence of identifiable risk factors or health concerns for the patients participating in the group session. The counseling should aim to reduce these risks and promote healthy lifestyle choices.
A group of patients with similar health status or risk factors meet with the provider to discuss how to use preventive measures to maintain health and how to reduce risk factors based on their unique circumstances. For instance, a group may consist of patients with weight concerns or asthma concerns. The provider holds the meeting for about an hour.
In simple words: The provider offers advice on maintaining and improving health to a group of patients for roughly an hour.
This code represents preventive medicine counseling and/or risk factor reduction interventions provided to individuals in a group setting. The service is considered a separate procedure and lasts approximately 60 minutes.It includes counseling/anticipatory guidance/risk factor reduction interventions provided to individuals in a group setting (e.g., weight loss, smoking cessation, stress management). The counseling provided often involves addressing family problems, diet and exercise, substance use, sexual practices, injury prevention, dental health, and diagnostic and laboratory test results.
Example 1: A physician conducts a 60-minute group session on diabetes prevention for patients at risk of developing the disease. The session covers topics such as healthy eating, exercise, and weight management., A nurse practitioner leads a one-hour group counseling session for pregnant women on prenatal care, including nutrition, exercise, and avoiding harmful substances., A registered dietitian facilitates a 60-minute group discussion for individuals with high cholesterol on heart-healthy eating habits and lifestyle modifications.
Documentation should include the date of service, the duration of the session, the topics covered, and the number of participants. It is crucial to document the specific risk factors addressed and the individualized advice given to each patient.
** This code is for group counseling and should not be used for individual counseling. Use code 99411 for group counseling of approximately 30 minutes. If the counseling provided is part of a larger service, do not report this code.
- Specialties:Internal Medicine, Family Medicine, Pediatrics, Obstetrics/Gynecology, and other specialties providing preventive care
- Place of Service:Office