Medicare and most private insurers pay for physicians, NPs and PAs to counsel patients about stopping tobacco use. The Medicare national payment rate is about $15 for 99406 and $28 for 99407.
The patient will be charged a co-pay and deductible. Private insurers can set their own policies and payments.
CPT codes for Smoking Cessation
There are two codes used to report counseling by a physician or non-physician practitioner (NPP) with the patient for smoking cessation.
99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes
99407 Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes
99407 is not an add-on code, and the two codes are never reported together. Report only one of the codes, depending on the time of the counseling.
According to Medicare, a physician or “other Medicare-recognized practitioner” may perform the service.
All patients who use tobacco are eligible, regardless of whether they have signs or symptoms or tobacco related diseases. Of course, the patient must be alert and competent at the time of the counseling. The service may be provided to inpatients or outpatients.
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