Enhanced reimbursement offered for smoking cessation counseling
Date: 08/05/16
Important Note: This offer expired on April 1, 2020.
MHS Health Wisconsin is focusing on a health concern that affects a significant number of our members: tobacco use. Smoking is 50 percent more prevalent among adult Medicaid members as compared to the general population. Medicaid covers counseling and medications.
MHS will pay an additional $10 (above the current reimbursement rate) for the following CPT codes:
Counseling, Smoking Cessation:
- 99406 – Tobacco use cessation counseling visit: intermediate, greater than 3 minutes up to 10 minutes (current reimbursement rate is $22.69; MHS Health will pay $32.69.)
- 99407 – Tobacco cessation counseling visit: intensive greater than 10 minutes (current reimbursement rate is $34.44; MHS Health will pay $44.44.)
Please note that one of the following ICD-10 codes must be billed in conjunction with codes 99406 or 99407:
- F17200, F17201, F17203, F17208, F17209, F17210, F17211, F17213, F17218, F17219, F17220, F17221, F17223, F17228, F17229, F17290, F17291, F17293, F17298, F17299, Z720
- Placed in the 1st- 4 th position on the claim
Medicaid also covers nicotine gum, patches, inhalers and sprays, bupropion SR (Zyban), and Chantix.
Thank you for helping us to transform the health of the community one person at a time. If you have any questions, please call Provider Services at 800-222-9831.