Preventive visit · CPT 99395

What is CPT code 99395?

Routine annual wellness visit, adult age 18-39 (established patient).

By Justin Feldstein · Reviewed 2026-06-15

What it covers

This is the routine annual physical or wellness visit for an adult between 18 and 39 who already sees the practice. It covers the preventive checkup: an age-appropriate exam, a review of your health history, counseling on things like diet and lifestyle, and ordering routine screenings. It's the 'free annual' most insurance plans cover at no out-of-pocket cost, and it is specifically not a visit to work up a new symptom or manage an ongoing condition.

When you'd see it

You'll see this after your yearly checkup or annual physical with your primary care provider, the visit you book just to stay on top of your health.

Roughly what it costs

$150–$400 commonly billed

A ballpark on the billed amount. After insurance or a negotiated rate, what you owe is often far lower. Always compare against your Explanation of Benefits (EOB).

What's usually billed with it

Routine screening labs ordered at a physical are billed separately under their own codes, which is expected; the charge to scrutinize is a separate problem-focused office visit attached to the same day.

99395 vs 99396

These preventive codes are chosen by age alone, so at 40 the visit moves to 99396; the content is the same, just a different age band. See 99396 (Preventive 40-64).

What to watch for

The most common surprise here is a covered annual that comes back with an extra office-visit charge; if you only went in for your routine physical, ask the billing office what separate problem justified the added 99213/99214 line and whether it was truly distinct from the wellness visit.

Specific things to question

• Your 'free' annual quietly billed as (or alongside) a problem-focused office visit such as 99213 or 99214, often with a modifier 25, leaving you a bill for a visit you expected to be covered.
• A passing mention of a minor issue during the physical turned into a separate, billable problem visit.
• The preventive visit denied for an age mismatch if coded in the wrong band.

How to check this charge on your own bill

Find 99395 on your itemized bill and match it against your EOB. Confirm it appears only once, that any bundled services aren't also billed separately, and that the amount matches what your insurer says it allowed. If something doesn't line up, that's a fair question for the billing office.