Smoking Related Disease No Longer Required For Tobacco Cessation Counseling

September 6th, 2010

On August 25 CMS announced a change in reimbursement policy for tobacco cessation counseling.  In the past, to bill for Tobacco Cessation Counseling, a smoking related disease diagnosis had to be linked to codes 99406 (three to ten minutes) and 99407 (more than ten minutes).

Medicare alloweds for these codes are approximately $13 and $25, slightly more or less depending on your jurisdiction.

CMS announced that “under new coverage, any smoker covered by Medicare will be able to receive tobacco cessation counseling from a qualified physician or other Medicare recognized practitioner who can work with them to help them stop using tobacco.”  Thus, the only diagnosis now required is 305.1, tobacco use disorder.

The new tobacco cessation counseling coverage expansion applies to services under Medicare Part B and Part A. “The new benefit will cover two individual tobacco cessation counseling attempts per year.Each attempt may include up to four sessions, with a total annual benefit thus covering up to eight sessions per Medicare patient who uses tobacco.”

“For too long, many tobacco users with Medicare coverage were denied access to evidence based tobacco cessation counseling,” said Kathleen Sebelius, HHS secretary, the August 25 statement. “Most Medicare beneficiaries want to quit their tobacco use. Now, older adults and other Medicare beneficiaries can get the help they need to successfully overcome tobacco dependence.”

Tobacco counseling must be done according to a plan.  The websites  and both have programs that may be adopted and used for counseling.  Simply telling a patient to quit smoking is not sufficient. 


There are no comments yet.

Leave a comment

Do not fill in this email field. It is used to detect spam bots.
Do not fill in this comment field. It is used to detect spam bots.
Recent Blog Posts
Recent Tweets