Medicare Compliance & Reimbursement

New coverage announcement is triumph for physicians who haven't collected in the past. 

If you've been writing off tobacco cessation counseling as nonpayable, it's time to change your tune. In the past, you could collect for codes 99406"99407 (Smoking and tobacco use cessation counseling visit...) if you performed tobacco cessation counseling for a patient with a tobaccorelated disease or with signs or symptoms of one. But on Augt.

25, 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 Medicarerecognized practitioner who can work with them to help them stop using tobacco."

"For too long, many tobacco users with Medicare coverage were denied access to evidence-based tobacco cessation counseling," said Kathleen Sebelius, HHS secretary, in an  Aug. 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."

The expanded coverage announcement was part of a focus in the Affordable Care Act that expanded preventive care service coverage. The new tobacco cessation counseling coverage expansion will apply to services under Medicare Part B and Part A.

"The new benefit will cover two individual tobacco cessation counseling attempts per year," CMS indicated in an Aug. 25 news release. "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." "We know that older adults and other Medicare beneficiaries can be successful in their struggles to stop using tobacco, as long as they have the right resources available to them," said HHS's Howard Koh, MD, MPH in an Aug. 25 statement.

"Today's decision will assure that beneficiaries can access that help from qualified physicians and other Medicarerecognized practitioners."

To read the complete coverage decision, visit www.cms.gov/center/coverage.asp, click on "NCAs," then scroll down to "Smoking & Tobacco Use Cessation Counseling."