Medicare and tobacco cessation counseling
Fam Pract Manag. 2007 May;14(5):11-12.
Kent Moore's article “What's New in Medicare Preventive Benefits” [February 2007] is a nice review of the preventive services coverage that the Centers for Medicare & Medicaid Services (CMS) provides. As the director of the Ohio Health Nicotine Dependence Program, I noticed a new, important benefit was omitted from the article: tobacco cessation.
In March 2005, CMS determined that coverage should begin for tobacco-use cessation for Medicare beneficiaries. Medicare covers two quit attempts per year, with a maximum of four intermediate or intensive counseling sessions per year (eight sessions per 12-month period). Patients with a tobacco-related condition or symptom are covered as well as patients who are advised to quit because tobacco use is affecting their metabolism or dosing of a therapeutic agent. Documentation of the tobacco-related condition is required.
Hospital-based counseling is also covered by Medicare Part D, but tobacco dependence cannot be the reason for the admission. Physicians and other clinicians recognized by Medicare may bill for tobacco-use cessation services using HCPCS codes G0375 (3 minutes to 10 minutes of counseling time) and G0376 (greater than 10 minutes).
Medicare does not categorize tobacco-use cessation services as a preventive benefit, which is why they were not covered in Kent Moore's article. These services are described in detail in the May 2006 FPM article “An Update on Tobacco Cessation Reimbursement.”
WE WANT TO HEAR FROM YOU
Send your comments to email@example.com. Submission of a letter will be construed as granting AAFP permission to publish the letter in any of its publications in any form. We cannot respond to all letters we receive. Those chosen for publication will be edited for length and style.
Copyright © 2007 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact firstname.lastname@example.org for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions
More in FPM
Related Topic Searches
MOST RECENT ISSUE
Access the latest issue
of FPM journal
Maternal Immunization Task Force for Pregnant Women: A Call to Action
The current increase in hesitancy about the safety and efficacy of vaccines has created an environment that calls for physicians’ urgent commitment to discussing the evidence-based benefits of vaccination with pregnant women.
Keys to High-Quality, Low-Cost Care: Empanelment, Attribution, and Risk Stratiﬁcation
Understand attribution and alignment methodologies in value-based payment arrangements to know which patients are assigned to you. Use empanelment and risk stratification to better understand where to expend your practice's care management and care coordination resources.