99401-99404 with Anthem Blue Cross and Blue Shield: what the policy says
By Javier Alvarez · Updated · 2 min read
1 row: Anthem Blue Cross and Blue Shield. Public policy, not the member's benefits.
Anthem Blue Cross and Blue Shield
Commercial · CO, CT, GA, IN, KY, ME, MO, NV, NH, NY, OH, VA, WI
| 97802 | Listed [1] |
|---|---|
| 97803 | Listed [1] |
| G0270 | Listed [1] |
| G0271 | Listed [1] |
| Where it applies | Anthem's commercial plans in CO, CT, GA, IN, KY, ME, MO, NV, NH, NY, OH, VA and WI. Other Blue plans publish their own policies. [1] |
| Diagnoses | Obesity rows: primary Z71.3, Z72.3 or Z72.4; secondary Z68.30 to Z68.45 or E66.01, E66.09, E66.1, E66.8, E66.9. Healthy diet row: Z71.3 or Z83.42 when the counseling is outside a preventive visit. [1] |
| Other codes | 97804 and S9470; 99401 to 99404. [1] |
| Telehealth POS | POS 02 or 10, for a code in CPT Appendix P. Professional virtual visits are "eligible for non-office place of service reimbursement". [2] |
| Telehealth modifier | 95 or GT for audio and video; 93 or FQ for audio only. [2] |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | Not published: call the payer. |
- Anthem Blue Cross and Blue Shield: ACA preventive care coding guidelines, commercial (August 2026), checked October 30, 2026
- Anthem: Commercial Reimbursement Policy C-08002, Virtual Visits, approved 03/26/2026 (PDF), checked October 22, 2026
What Anthem Blue Cross and Blue Shield's policy says about 99401-99404
99401-99404 is the CPT code for preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure), approximately 15, 30, 45 and 60 minutes. At Anthem Blue Cross and Blue Shield it is listed: named in the payer's public policy. Each line below is from Anthem Blue Cross and Blue Shield's own text:
- Where it is listed. Listed with the MNT and behavioral counseling codes on the adult BMI 30 or higher row. (Anthem Blue Cross and Blue Shield, checked October 30, 2026)
- Billed with. Healthy diet row diagnosis: Z71.3 or Z83.42. Obesity rows: primary Z71.3, Z72.3 or Z72.4. (Anthem Blue Cross and Blue Shield, checked October 30, 2026)
- When it pays. Normally part of a wellness office visit. Outside one, a listed diagnosis code is required. (Anthem Blue Cross and Blue Shield, checked October 30, 2026)
- Also. Also used for intimate partner violence screening counseling with Z69.11 or Z69.8. (Anthem Blue Cross and Blue Shield, checked October 30, 2026)
99401-99404 at other payers
- 99401-99404 with BCBS of IL, TX, OK and NM (HCSC): limited.
- 99401-99404 with Blue Cross NC: listed.
- 99401-99404 with Blue Cross Blue Shield of Massachusetts: limited.
- 99401-99404 with UnitedHealthcare: listed.
- 99401-99404 with Cigna: listed.
The rest of Anthem Blue Cross and Blue Shield's MNT rules
The Anthem Blue Cross and Blue Shield row has its codes, telehealth rule, limits and referrals, each with its source. Other codes we checked at Anthem Blue Cross and Blue Shield: Z71.3, 97803, E66, Z68 and G0447. What 99401-99404 means at any payer is on the 99401-99404 code page. Before the claim goes out, compare it with the row in the table above, then download the PDF of what you see.