How to Bill CPT 99396 for Preventive and Wellness Services

When to Use CPT Code 99396

CPT 99396 is used for preventive and wellness services, focusing on screening, risk assessment, and health maintenance rather than problem-oriented care.

• •Service type: Preventive care
• •Focus: Health promotion and disease prevention
• •Who bills it: Physicians and qualified healthcare providers

Common scenarios:

• •Annual physical or wellness exams
• •Age-appropriate preventive screenings
• •Lifestyle and risk-reduction counseling

Insurance Verification Tips for CPT 99396

1. •Confirm patient eligibility for preventive services.
2. •Verify age and patient-status requirements.
3. •Ensure no problem-oriented E/M services are billed concurrently.
4. •Document preventive intent clearly.

Example Case of CPT 99396

A provider conducts a preventive visit focused on screenings and counseling appropriate to the patient’s age and risk profile.
The encounter is documented and billed as one unit of CPT 99396.