Skip to Main Content

KMAP BULLETIN: Smoking and Tobacco Cessation Counseling

Date: 05/04/20

UPDATEDKMAP GENERAL BULLETIN 19025 (PDF)

For dates of service on and after July 1, 2018, tobacco cessation counseling can be provided to any Medicaid beneficiary who is a current tobacco user. The providers that can deliver this service and bill it are as follows.

  • Individual counseling for smoking and tobacco usage can be provided and billed by any provider who has education and/or counseling within their scope of practice. CPT® codes 99406 and 99407 are billable by:
    • Physician
    • Mid-level practitioner (such as nurse practitioner, physician assistant)
    • Mental health provider
    • Clinic (such as Federally Qualified Health Center [FQHC], rural health clinic [RHC], and local health department) (Excluding Dentists)
    • Hospital
    • Home Health Agency
    • Indian Health Services
  • Group counseling for tobacco cessation can be provided by a clinic or physician’s office. HCPCS code S9453 is billable by:
    • Physician
    • Mid-level practitioner (such as nurse practitioner, physician assistant)
    • Mental health provider
    • Clinic (such as FQHC, RHC, local health department, and community mental health center [CMHC]) (Excluding Dentists)
    • Indian Health Services

Tobacco cessation counseling (individual and group) can also be provided by any provider who has education and/or counseling within their scope of practice, as long as the service is under the supervision of a physician or midlevel practitioner. This includes those individuals who have a Tobacco Treatment Specialist certificate from a program accredited by the Council for Tobacco Treatment Training Programs. The Tobacco Treatment Specialist has to be employed by a clinic or physician’s office that is an enrolled KMAP provider to bill for the service.

This bulletin is for clarification purposes and is related to KMAP General Bulletin 18163 published in August 2018.