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CPT 99409

No national payment amount

Status N is not separately payable under the PFS.

Non-covered service. Not paid by Medicare.

Common questions

Why is there no payment amount for 99409?

Its status indicator is N (non-covered). Non-covered service. Not paid by Medicare. The blank is deliberate: the amount is unknown or paid another way, not zero.

When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October). Each release is versioned here, so past quarters stay lookupable — see what changed each release, or get an email when a new release moves rates.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Saw this code on your bill?

What is a 99409 visit in patient-friendly terms?

CPT 99409 is a billing code clinicians use to identify a specific service or procedure on a claim or explanation of benefits (EOB). We don't have a plain-language description on file for this exact code yet — ask your provider's billing office what service it represents, or bring it up at your next visit.

How this amount is computed

amount = (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × conversion factor. National amounts use GPCI = 1.000.

Release Q3 2026

Every rate combines three parts: work (the clinician’s time, skill and effort), practice expense (office overhead — higher when the service is done in a doctor’s own office), and malpractice (the share of liability-insurance cost). A value of blank means CMS publishes no national number for that part — which is not the same as zero.

Rate history by release

National non-facility amount for 99409 across quarterly releases. Up 6.4% since Q1 2025 · high $67.47 in Q1 2026

$67 $64 $61 $58 $55 Q1 2025 · $63.40 Q2 2025 · $63.40 (0.0%) Q3 2025 · $63.40 (0.0%) Q4 2025 · $63.40 (0.0%) Q1 2026 · $67.47 (+6.4%) Q2 2026 · $67.47 (0.0%) Q3 2026 · $67.47 (0.0%) Q1 2025 Q2 2025 Q3 2025 Q1 2026 Q2 2026 Q3 2026
Non-facility Facility
Release Status Non-facility Facility
Q3 2026 Jun 30, 2026 N $67.47 (0.0%) $55.45 (0.0%)
Q1 2026 Dec 29, 2025 N $67.47 (+6.4%) $55.45 (-8.8%)

Billing together (NCCI edits)

NCCI Q3 2026

Per CMS's National Correct Coding Initiative. Hover a code for when it's used.

Never billable with 99409 on the same date of service

0395T 0469T 36591 36592 80503 80504 80505 80506 90791 - Psychiatric Diagnostic Evaluation 90792 90832 - Individual Psychotherapy, 30 Minutes 90833 90834 - Psychotherapy, 45 Minutes 90836 90837 - Psychotherapy, 60 Minutes 90838 90845 90846 90847 90849 90853 - Group Psychotherapy 90880 93793 94002 94003 +115 more

Billable with 99409 only with modifier 59, XE, XS, XP, or XU

Source & method

Computed from the CMS Medicare Physician Fee Schedule Q3 2026 release (schedule pfs, effective July 2026). National amounts apply a GPCI of 1.000 and exclude sequestration. Payability follows the status indicator, not RVU values — blank RVUs are never treated as zero. Releases are immutable; a rate retrieved for a past quarter always reflects that release.

Physician relative value file (Q3 2026) · rvu26c-updated-06-30-2026.zip (PPRRVU2026_Jul_nonQPP.csv row 13,034)

Conversion factor $33.4009 read from the same file, row 11, column 26.

Use the (i) buttons next to each amount above for the exact row, columns, and math.