As of August 25, 2010, more of your patients who use tobacco are eligible for Medicare Part B benefits for tobacco and smoking cessation counseling. Tobacco and smoking cessation counseling is now covered not only for those patients who have a condition adversely affected by tobacco use, but also for those patients who are asymptomatic.
In a transmittal to Medicare contractors dated September 30, 2010, the Centers for Medicare and Medicaid Services provided details on how the expanded benefits are to be reported.
This was successfully posted to your pofile.
This box will close automatically in a few seconds. Close this window
We don't have an e-mail address on file for you. To use AAFP Connection, you must have an e-mail address in our records. Click Here
Tobacco Cessation Counseling Benefits 2010-2011
New Codes and New Rules to Watch
This information is a bit complex as the expansion of the current benefit to asymptomatic patients changed again on January 1, 2011, when Medicare payment for preventive services with a Grade A or Grade B rating by the United States Preventive Services task force are no longer subject to deductible or co-insurance.
Services provided to asymptomatic patients on or after January 1, 2011, will be reported with HCPCS G-codes, G0346 and G0347. These services will be paid under the new preventive services benefits for 2011 with no out-of-pocket expense to the patient. Services provided to patients who are not asymptomatic of a tobacco-related condition will still be reported with CPT codes 99406 and 99407 and will be subject to the Medicare Part B deductible and co-insurance.
To aid you and your staff in choosing the correct codes and determining patient responsibilities during this time of transition, a table (1-page PDF file; About PDFs) of the specifics for each reporting scenario may be downloaded or printed as a reference.
Services provided to asymptomatic patients on or after January 1, 2011, will be reported with HCPCS G-codes, G0346 and G0347. These services will be paid under the new preventive services benefits for 2011 with no out-of-pocket expense to the patient. Services provided to patients who are not asymptomatic of a tobacco-related condition will still be reported with CPT codes 99406 and 99407 and will be subject to the Medicare Part B deductible and co-insurance.
To aid you and your staff in choosing the correct codes and determining patient responsibilities during this time of transition, a table (1-page PDF file; About PDFs) of the specifics for each reporting scenario may be downloaded or printed as a reference.
Coding Resources and Assistance
Anatomy and Terminology
Associations
Billing and Claims
Use Teamwork to Manage Accounts Receivable (*PDF file)
Billing Process Checklist (*PDF file)
Using Revenue Reports (*PDF file)
Claim Form 1500 and Instructions
Financial Hardship Template (**Word file)
Compliance
Code of Conduct (**Word file)
OIG compliance plan (*PDF file)
Record Request Checklist (*PDF file)
Chart Review Self-Audit Tool from FPM
CMS Non-Covered Services
Beneficiary Notice 2011- English (*PDF file)
Beneficiary Notice 2011- Spanish (*PDF file)
Coding Contacts
Coding Tips and Courses
Code Lists
ICD-10-CM Files from National Center for Health Statistics
Diagnosis Coding
Evaluation and Management (E/M) Coding
E/M Documentation Guidelines from CMS
FPM: Documenting History in Compliance With Medicare's Guidelines
FPM: Exam Documentation: Charting Within the Guidelines
FPM: Thinking on Paper: Documenting Decision Making
FPM: Is Your Medicare Payer Playing by the Rules?
Maternity Care Coding
Coding for Intrapartum and Other Maternity Care
Medicare/Medicaid Coverage
Medicare Physician Fee Schedule Look-Up
Tobacco Cessation Counseling Benefits 2010-2011
National Coverage Determinations
Tips for 2011 CMS e-Rx Program (**Word file)
FPM: How to Code for Observation Services
Preventive Services Coding
Medicare Preventive January 2012 (*PDF file)
Quick Reference to Medicare Preventive Services (*PDF file)
(*PDF file. About PDFs)
(**Word file. About Downloading)
