Counseling to Prevent Tobacco Use — Reminder

The Centers for Medicare and Medicaid Services (CMS) will cover intermediate and intensive counseling to prevent tobacco use. The service must be provided by qualified physicians or practitioners for outpatient and hospitalized Medicare beneficiaries who use tobacco.

Counseling to prevent tobacco use is a time-based service. The physician or practitioner’s documentation must show the amount of time spent on each counseling visit.

• HCPCS Code G0436 — Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes
• HCPCS Code G0437 — Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes
• CPT Code 99406 — Smoking and tobacco cessation counseling visit; intermediate, greater than 3 minutes, up to 10 minutes
• CPT Code 99407 — Smoking and tobacco cessation counseling visit; intensive, greater than 10 minutes

Please note that minimal tobacco cessation counseling is already covered at each evaluation and management visit.

For additional information, please refer to the American Billing Association and the following resources:

• Medicare National Coverage Determinations Manual — 100-03, Chapter 1, Part 4, Sections 210.4 and 210.4.1
• Medicare Claims Processing Manual — 100-04, Chapter 18, Section 150
• MLN Preventive Services Educational Tool