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Bill for Smoking Cessation

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  • In Billing
  • August 25, 2011
  • Comments Off on Bill for Smoking Cessation

The smoking cessation codes have sparked a lot of attention lately. Yes, you really can bill for these services, but not every payer will reimburse you.
Let’s look at the codes and descriptor requirements. Note that if you counsel the patient for fewer than three minutes, you would not report these codes. Be sure that the time spent counseling is specified in the medical record.
CPT® Codes
99406 – Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes
99407 – intensive, greater than10 minutes
HCPCS Level II Codes
G0436 – Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes
G0437– intensive, greater than10 minutes
Payers who do not reimburse for these services may, nonetheless, apply the charges toward any unmet patient deductable. Other payers may bundle the services to any other E/M service on the same day. Check with your insurance plans for details, so that you are able to inform patients whether the service will be covered. Note that insurers may offer different plans with varying coverage. For example, Blue Cross/Blue Shield covers smoking cessation on some of their plans, but not on others.

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No Responses to “Bill for Smoking Cessation”

  1. Lori Frenzl says:

    i would like to find out if any specialty physician can bill for the smoking cessation codes 99406 and 99407 and the Medicare G0436 and G0437, or is it strictly for Primayr care physicians. Any help is appreciated.

  2. Deborah Hill says:

    Was the question about specialty ever answered? Can ALL of the patient’s physicians bill these codes, primary care and specialty? I am seeing lots of specialists billing this without having appropriate documentation of their counseling. Surely Medicare isn’t going to pay for multiple physicians of the same patient to bill and be paid.

  3. Elizabeth piwowarczyk says:

    Please I would like to know if cardiologist can bill these codes and what diagnosis can we use ??

  4. sandra johnson says:

    can we bill this if it is provided in the emergency room?

  5. Gina Jauregui says:

    How often can you bill for the smoking cessation per year? What type of documentation do we need to put on chart note if billed in addition to office visit?

  6. Megan Murphy says:

    It is an outrage that people are billed for this. I went to the hospital for strep medication when I moved off for college. The Dr. asked me if I smoked and I told him “Yes, I do”. He then asked if I ever considered quitting. “Of course I have but I don’t want to quit right now”, I get my meds and go home. They charged me $40.00 to tell me what I already know. How can you charge people for advise they didn’t ask for? On top of that the hospital claimed the doctors weren’t covered by my insurance only the hospital. Why wouldn’t you tell me that when I gave you my insurance card, before anyone even saw me? When I called to dispute the matter they claimed it was my responsibility to know. How am I supposed to know which Dr. is working and which will cover my insurance? It’s impossible.

  7. Michelle Yvette Durand says:

    I have been charge for smoking cessation counseling also..but from now on I will tell them that I decline counseling. Hoping that will work.