Healthcare Insights
Top 10 preventive medicine CPT codes
Preventive medicine is a type of medicine that protects patients and communities from avoidable disability, illness, and death. Healthcare providers offer testing, counseling, and immunizations to prevent illness and identify potential health concerns as they emerge.
Preventive medicine is a vital component of healthcare because it promotes overall wellness, reduces the occurrence of illness, and saves resources.
Using data from the Atlas All-Payor Claims Database, we compiled a list of the top 10 preventive medicine CPT codes below.
| Rank | HCPCS/CPT code | Description | % of total procedures | Explore dataset |
|---|---|---|---|---|
| 1 | 99396 | Preventive evaluation/management visit for established patient, age 40-64 | 19.58% | Explore |
| 2 | 99395 | Preventive evaluation/management visit for established patient, age 18-39 | 12.14% | Explore |
| 3 | 99392 | Preventive evaluation/management visit for established patient, early childhood | 11.43% | Explore |
| 4 | 99393 | Preventive evaluation/management visit for established patient, late childhood | 10.61% | Explore |
| 5 | 99391 | Preventive evaluation/management visit for established patient, infant | 9.97% | Explore |
| 6 | 99394 | Preventive evaluation/management visit for established patient, age 12-17 | 8.72% | Explore |
| 7 | 99397 | Preventive evaluation/management visit for established patient, age 65+ | 5.45% | Explore |
| 8 | 99385 | Initial preventive evaluation/management visit for new patient, age 18-39 | 3.73% | Explore |
| 9 | 99386 | Initial preventive evaluation/management visit for new patient, age 40-64 | 2.95% | Explore |
| 10 | 99401 | Preventive counseling and risk factor reduction for individual, 15 min. | 2.82% | Explore |
Fig. 1 Analysis of data from the Definitive Healthcare Atlas All-Payor Claims Database representing procedure claims for 2024. Data accessed August 2025.
What was the top preventive medicine CPT code?
The top preventive medicine CPT codes on our list are 99396, 99395, and 99392, which all refer to preventive visits for established patients among certain age groups. CPT code 99396 represents 19.58% of preventive medicine claims tracked in our database during 2024, while 99395 and 99392 represent 12.14% and 11.43% of preventive medicine claims for that time period respectively.
The code involves a routine, annual physical exam that includes a comprehensive review of systems, age-appropriate screenings, immunizations, and counseling on health maintenance. Because CPT code 99392 involves patients in early childhood, the tests typically focus on growth parameters, developmental milestones, immunization status and administration, counseling for parents and caregivers, and more.
What preventive care is not covered by Medicare?
Medicare Part B covers a wide variety of preventive and screening services for common chronic conditions as well as rare diseases, infections, and behavioral concerns. These include screenings for cancer, diabetes, glaucoma, cardiovascular disease, depression, sexually transmitted infections, and many other biomarkers and measurements.
Medicare does not cover preventive services related to most dental care, cosmetic dermatological conditions, and eye exams for the purpose of fitting glasses.
Learn more
To hear more about the long-term implications of pandemic-related delays in care, including preventive care, listen to our podcast with Dr. Mark Pimentel.
Healthcare Insights are developed with data from the Definitive Healthcare platform. Want even more insights? Start a free trial now and get access to the latest healthcare intelligence on hospitals, physicians, and other healthcare providers.
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