The Centers for Medicare & Medicaid Services (CMS) began covering tobacco cessation counseling for Medicare patients in 2010. Medicare covers and pays for services provided to Medicare patients using Healthcare Common Procedure Coding System (HCPCS) Level II codes.

Through research by the American Academy of Pediatrics Private Payer Advocacy initiative, it was learned that some of the largest national private carriers now cover and pay for smoking and tobacco use cessation counseling when reported using Current Procedural Terminology (CPT®) codes 99406 and 99407.

Some plans have annual limits to the number of smoking cessation counseling encounters that a physician may report, and others may have claim edits based on the patient's age. Therefore, it is important to verify payer coverage. Remember, if a payer does not cover a service, you may bill the family for the service if allowed under your contract. If doing so, do not...

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