CMS Transmittal R13945MPI: Updates to Chapter 3, Chapter 4, and Chapter 5 in Publication (Pub.) 100-15, Including Updates…
Medicaid
CPT procedure code
99397 — Preventive visit, established patient, age 65+
PreventiveCPT
Medicare payment
$138.95
2026 Physician Fee Schedule · non-facility
Source: CMS Physician Fee Schedule (PPRRVU 2026). CMS fee schedules ↗ · PFS status indicator N
National amount before geographic adjustment. Your MAC's locality rate will differ.
Code definition
Code
99397
Code system
CPT (Current Procedural Terminology)
Description
Preventive visit, established patient, age 65+
Category
Preventive
Short description sourced from CMS publicly available fee schedule data. Full CPT descriptions are copyright AMA. Not a substitute for the official CPT codebook.
Latest reimbursement alerts
No policy changes are currently matched to 99397. Here are the latest changes across all codes.
High
FDA Approval: RASONQUE (DARAXONRASIB) — Type 1 - New Molecular Entity
Oncology
FDA Approval: VOBRIG (LEUPROLIDE ACETATE) — Type 5 - New Formulation or New Manufacturer
Oncology
FDA Approval: NDA 220106 — Type 1 - New Molecular Entity
Multi-specialty
FDA Approval: BIXLENVO (BICTEGRAVIR/LENACAPAVIR) — Type 4 - New Combination
Infectious Disease
FDA Approval: NDA 221443 — Type 4 - New Combination
Multi-specialty
Audit documentation
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Related CPT codes (993xx)
99304E/MNursing facility initial care, low complexity
99305E/MNursing facility initial care, moderate complexity
99306E/MNursing facility initial care, high complexity
99385PreventivePreventive visit, new patient, age 18-39
99386PreventivePreventive visit, new patient, age 40-64
99387PreventivePreventive visit, new patient, age 65+
99395PreventivePreventive visit, established patient, age 18-39
99396PreventivePreventive visit, established patient, age 40-64
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