The counseling most clinicians already do, unpaid for want of one documented number.
| Code | Counseling time | wRVU |
|---|---|---|
| 99406 | More than 3 minutes, up to 10 | 0.24 |
| 99407 | More than 10 minutes | 0.50 |
Both are add on style services reported alongside the visit; they are not a substitute for it. The gate is the word MORE: exactly 3 minutes supports neither code, which is why a note that says "counseled about 3 minutes" earns nothing while "spent 4 minutes counseling on tobacco cessation" earns 0.24.
Three things: the tobacco use, the counseling content (advised quitting, discussed methods, pharmacotherapy, or referral), and the exact minutes as a number. The minutes are the element clinicians skip, and the counseling then vanishes at coding.
Medicare covers two cessation attempts per 12 months, each with up to four sessions, a ceiling of eight counseling sessions a year, and covers them for any tobacco user. Commercial coverage is broadly similar under preventive benefits; verify the plan when this becomes routine in your clinic.
A surgeon or clinician who addresses smoking with every user, a habit that improves the outcomes of everything else you do, and documents the minutes, adds 0.24 to 0.50 wRVU to each of those visits. Across a year of clinic that is real money for work already being done. This exact code is where many providers first discover the pattern: performed, documented, and still unpaid for want of one number.
Paste a visit into the E/M Assistant; when cessation counseling appears without minutes, the coaching names the sentence that captures it. Copy ready phrases live in the documentation templates.